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(11-05-02) Transportation Services Motor Coach Rentals
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Last modified
5/25/2011 2:31:08 PM
Creation date
5/25/2011 2:31:03 PM
Metadata
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Transportation Services
Bid No. (xx-xx-xx)
11-05-02
Project Type (Bid, RFP, RFQ)
Bid
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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) 947-0606 Fax: (305) 949-3113 <br /> <br />ANTI -KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF Uf\bE <br /> <br />) <br />) <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)L( ~MlrrJ <br />()Wt0~ <br /> <br />Title: <br /> <br />The foregoing instrument was acknowledged before me this .2 'IrJ/ day of <br />MAl{ , 20-1L, by <"Rjo,<..iOt.t 8H /771 [name <br />of person], as G>c..c..>,.) rl< [type of authority], for <br />l>>J l Gl0C= c ft-1'tiL TC(<. S, I r.-JL... [name of party on behalf of whom instrument was <br />executed] . <br /> <br />AFAX NOTARY STAMP HERE: <br /> <br /> <br /> <br />................................................. <br />; RICHARD A. NZERIBE : <br />; ~...,\.\\\tIt::II~/~ : <br /> <br />_ ~ CQ(l)misf4n~~ Ncime <br />, ~t~"tJ:?\.~\.#. : <br />"';;;,;1\'" Flonda Notary Assn" Inc ~ <br />.- ~, .,~.-,..~,. ?~':'~"'! "';!!~. ~." _~.... ..."Il'l..,"".lfl....'. ," <br /> <br />Personally Known ~ OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMeER 28, 2010 <br /> <br />70f7 <br />
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