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(08-10-01) Streetscape Improvements
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Last modified
4/12/2011 4:46:04 PM
Creation date
4/12/2011 4:45:54 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Streetscape Improvements
Bid No. (xx-xx-xx)
08-10-01
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 />COUNTY OF t::nk <br /> <br />) <br />) <br />) <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein bid will be paid <br />to any employees of the City of Sunny Isles Beach or its elected officials as a commission, kickback, <br />reward or gift, directly or indirectly by me or any member of my firm 0 n officer of the corporation. <br /> <br />By: <br /> <br /> <br />Title: <br /> <br />The foregoing instrument was acknowledged before me this ~ day of D~ Ce,(Y) be ( , <br /> <br />20~, by Q)(1f \ st-l Q f) <br /> <br />\r \ l€- 9-04..&' d-e {) .\. [type of authority], for '5 V'~ ~Y''' iceS j In-C <br />[name of party on behalf of whom instrument was executed]. <br /> <br />\nf-ante <br /> <br />[name of person], as <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />NOTARY PUBLIC-STATF.OF FLORIDA <br />".....,,'.. Vanessa V. Herrera <br />{W' Commission # DD708577 <br />'t...'!IIl..i Expires: AUG. 26, 2011 <br />B~ED THRU ATLAImCBONDING co..INC. <br /> <br /> <br />"A-uq ale I 20\ I <br />Print or Type Commissioned Name <br /> <br />Personally Known <br /> <br />x <br /> <br />OR Produced Identification <br /> <br />Type of Identification Produced <br /> <br />END OF SECTION <br /> <br />PAGE 82 OF 130 <br />BID No. 08-10-01 <br />
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