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0 0 <br />F <br />Y <br />r <br />v. <br />tiE /DD�•FlO Q"a ye <br />C,tY OF SUN Pd0 <br />STATE OF FLORIDA ) <br />COUNTY OFwL� °� ) <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. r, <br />The foregoing <br />vkc_Q L <br />of pe n], as <br />executed]. <br />0 <br />Title: <br />instrument was acknowledg -1 before me this Z4 day of <br />20 LV by , n\ [name <br />-= C_PC [type of authority], for <br />_ [name of party on behalf of whom instrument was <br />AFFIX NOTARY STAMP HERE: <br />'P YVETTE SANZ <br />MY COMMISSION # DD 993066 <br />EXPIRES: September 18, 2014 <br />' Bonded Thru Notary Public Underwr ters <br />Nota ublic — State of Florida <br />(A t"p-k-, _S�Ctn'--L <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 7 <br />