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(11-05-02) Transportation Services Motor Coach Rentals
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Last modified
5/25/2011 2:33:41 PM
Creation date
5/25/2011 2:33:36 PM
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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 />Or \\J~ <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 Dade <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 />BrellBrittenum g~~// _~ <br />..-- ...-- <br />Vice President & General Manager <br /> <br />Title: <br /> <br />The foregoing instrument was acknowledged before me this c;;! 0 day of <br />Hr~1 , 20~, by Bret T. Briltenum [name <br />of personj, as Vice President & General Manager [type of authority], for <br />American Coach Lines of Miami, Inc. [name of party on behalf of whom instrument was <br /> <br />executed] . <br /> <br />NOTARY PUBUC-STATE OF FLORIDA <br />..,......,'", Jecic Molina <br />~ .\tJi.! i Commission # DD87661S <br />~.~..., Expires: JULY 07, 2013 <br />BONIlED TIlRU hTLhNTIC BONDING CO.,INe. <br /> <br />~) ? --- -1 <br />~ <br />otary Public - State of Florida <br /> <br />p ~\ /-CCrf_ t--!u LI00, <br />Print or Type Commissioned Name <br /> <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Personally Known / OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28. 2010 <br /> <br />7 of 7 <br />
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