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SUNNY rs4BJ. <br />04 9 <br />a F <br />V — _ <br />SF y�f FLO"'V sr <br />c, "o <br />r' or suN n <br />STATE OF FLORIDA ) <br />COUNTY OF DO 0-- ) <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: b ' �G <br />Title: Pre- side,.o ` <br />The foregoing instrument wastecknow dged before me this 23,-o day of <br />7qa � , 20 bjy( tKo �i [name <br />of person , ,as � 1 CA [type of authority], for <br />/J�r1 V / � o acs [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Notary Public — StA6 of Florida <br />C�ARLOS R. PERNIA <br />MY COMMISSION # DD 741526 <br />*� EXPIRES: January 7, 2012 <br />.�, Borded Thru Notary <br />Public Undarwraers <br />C a4 I 'j 12 - PC A '� I &:j- <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification - <br />Type of Identification Produced <br />DECEMBER 28, 2010 % Of 7 <br />