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<br />n <br /> <br />. <br /> <br />,.., <br /> <br />. <br /> <br />.., <br /> <br />. <br /> <br />,.., <br />. <br /> <br />,., <br />. <br /> <br />.., <br /> <br />. <br /> <br />n <br />. <br /> <br />,., <br /> <br />. <br /> <br />..., <br /> <br />. <br /> <br />,.., <br /> <br />- <br /> <br />,.., <br /> <br />. <br /> <br />r"'1 <br /> <br />. <br /> <br />n <br /> <br />. <br /> <br />M <br /> <br />III <br /> <br />r"! <br /> <br />. <br /> <br />.., <br /> <br />. <br /> <br />n <br /> <br />. <br /> <br />M <br /> <br />. <br /> <br />,.... <br /> <br />. <br /> <br /> <br />ANTI-KICKBACK <br /> <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-3113 <br /> <br />Of S1Jl'l <br /> <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUN1Y OF fL <br /> <br />) <br />) ~ ()Jvi.M' Dodo ' <br />) <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 City 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 />By: <br /> <br />t\,(Lrncto(~D Cc~sh\ to <br />'J.l ~ R~')t / Q\J~\'I'Ji?,f <br /> <br />{(, <br /> <br />Title: <br /> <br />. ^ The foregoing instrument was ackno}'Vleqged. before me this <br />~'~ ' 20lL by ~~ lu')fl (ro <br />of per on], as 0 \Co PCQ ~( . - [type of <br /> <br />day of <br />[name <br />authority], for <br /> <br />r n~........o ""f r"\":)rh, ^" ho.h-:.lf "of ,uhl"'\rY'\ int""........ n"'no.n+- u,":)r <br /> <br />p>yp.rlltp.rll <br />-- ------ <br /> <br />"':';;~~::'" CLAUDIA BALAREZO <br />lm~ ;;'~ Notary Public . Stlte of flofIfa <br />i. . E My Comm. expires Now 2. 2014 <br />\:4'it .,.,{>"/ Commission fI EE 39632 <br />...#/"r:.:.\....,. Bonded TIlrOllllh IaIionaI .... <br /> <br />~(W-tCt.~ gq(Cl'1( cD <br />Print or Type Commissioned Name <br /> <br /> <br />Personally Known OR Produced Identification'l. <br />Type of Identification Produced \) l 'f \ CZ'3 It 320 ~ Z I qO f() <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 10 <br />