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I"ANY IS, <br />S <br />OF �A <br />V I <br />_ r <br />tir D9�. i�ON�O y�,r <br />�r o <br />• O? <br />STATE OF FLORIDA ) <br />COUNTY OF C,w�►'� -t� ) <br />ANTI - KICKBACK <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 />ANTI - KICKBACK AFFIDAVIT <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 />By: a�. <br />Title: 190&5 l 00�, 5 1 <br />The foregoing instrument was acknowledged before me this Z / day of <br />,�rr- 20 1 , by _-S caLiAn A [name <br />of per on], as Po2 t'5 iaoi-r [type of authority], for <br />As,A 00,0�v EF sI)&- 5�_- oyicCS [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />OM SOIO "^%My combpm E6 <br />�a EXPUM: oao>>a 28, 2014 <br />Ia0U3 -WARY NduY Dnoowt Avoc. Co. <br />Personally Known <br />Type of Identification Produced <br />dJ�,7n A A0j1---4 — <br />Notary Public — State of Florida <br />Print or Type Commissioned Name <br />OR Produced Identification <br />DECEMBER 28, 2010 7 of 7 <br />