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(08-06-02) Janitorial Maint. Svcs,
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Last modified
3/10/2011 5:00:01 PM
Creation date
3/10/2011 4:55:07 PM
Metadata
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CityClerk-Bids_RFP_RFQ
Project Name
Janitorial Maint. Svcs.
Bid No. (xx-xx-xx)
08-06-02
Project Type (Bid, RFP, RFQ)
Bid
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<br />- <br /> <br />SECTION 21 <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />COUN1Y OF &-OlLlt1cL~ <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum <br />herein bid will be paid to any employees of the City of Sunny Isles Beach or its elected <br />officials as a commission, kickback, reward or gift, directly or indirectly by me or any <br />member of my firm or by an officer of the corporatio <br /> <br />By: <br /> <br /> <br />Title: <br /> <br />was executed]. <br /> <br />\ The foregoing instrument was ac~nowledged before me, this ti day of <br />,\ J~ , 20---'2L by tlhttlVfrJiJIf ((oem /b) 12-24 vr 0 <br />[name of person], as [type of authority], for <br />[name of party 0 behalf of whom instrument <br /> <br />j) <br /> <br /> <br />~~~W~ <br />AFFIX ~~~... ~ HERE: <br /> <br />~S::-o ..- -.. ~ <br />~~ .~~~ tIt;- .:.. ~ ~ <br />....,....... "" L'-O;.""'-::::- <br />....(') .,;p~ 0 ''Z-~.~- <br />~;"ll!il- 0, % ~~ oE <br />:;!:3=g ~. ~~:-<- <br />- '-I . ~ ~ -. ,'" is . ;!:: <br />--rT'.'i. ~ (I, ~::b, - \ <br />~Q..'% - ",,<::J .^'.... <br />-';;;(\ ..~~ '" ':\.- . (\i:.;:;" <br />.~ ".> ... S3'O'':..,...... ~ <br />persori~~q(r1ijwii. ~~" OR Produced Identification <br />Type of IdgfWlfl~ Ion P 0 ed <br /> <br />END OF SECTION <br /> <br />PAGE 77 OF 78 <br />
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