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Reso 2011-1699
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Reso 2011-1699
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Last modified
7/28/2011 11:32:48 AM
Creation date
5/9/2011 10:59:20 AM
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Template:
CityClerk-Resolutions
Resolution Type
Resolution
Resolution Number
2011-1699
Date (mm/dd/yyyy)
04/21/2011
Description
Awd RFP 11-02-01&Agmt w/Snack Time:Concess. Samson Oceanfront Pk
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<br /> <br />ANTI-KICKBACK <br /> <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, Fl 33160 <br />Telephone: (305) 947-ll606 Fax: (305) 949-3113 <br /> <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />COUNlY OF ~ ~ <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br />will be paid to any employees of the Oty of Sunny Isles Beach or its elected officials as a <br />commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or <br />by an officer of the corporation. <br /> <br />II\The foregoing instrument was acknowledged before me this <br />rV\(l.Q.\ . 20-1L-, by <br />of person], as <br /> <br />By: TuYt{F;. (dcrSL-(L <br /> <br />-- I <br /> <br />Title: V\IlO- &<A 0 '"j r~:u'J Cd-V <br />D~ <br /> <br />day of <br />[name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br /> <br />executed]. <br /> <br /> <br />/~~~f~~ JASON R WESTFORT <br />- . ~*~ MY COMMISSION # DO 992109 <br />. : = EXPIRES: June 13, 2014 <br />. Bonded Thru Notary Public Underwriters <br /> <br /> <br />f <br />[\ <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />\ <br /> <br />( <br />( <br /> <br />Personally Known -.L:R Produced Identification <br />Type of Identification Produced <br /> <br />( <br />\. ." <br /> <br />( <br />\. <br /> <br />I <br />\ <br /> <br />, <br />\. <br /> <br />\. <br /> <br />'" <br /> <br />\. <br /> <br />DECEMBER 28, 2010 <br /> <br />70f7 <br /> <br />'. <br /> <br />\. <br /> <br />, <br /> <br />22 <br />
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