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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 ~OlOCtvc!- ~ <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 />Title: l\'-e~ cl-el---Y <br /> <br />. J The foregoing instrument was acknowledged before me this lie day of <br />J:j (.,V\ , 20~, by rJ,,(jS.+i~ 'Ad-Pri /"'In ~n [name <br />of p~rson], as ~~<;')d.pw- [type of authority], for <br />K-P~ R. 10 f.t. P Cfr,-+~r ntl 'I,'cnc< f COr f' [name of party on behalf of whom instrument was <br />executed] . <br /> <br />~~ p~ Notary Public State of Florida <br />R~'" Pamela L James <br />~ ; My Commission 00908709 <br />"'~o,,,,rP Expires 08/17/2013 <br /> <br /> <br /> <br />tV1~ <br />tate of Florida <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Print or Type Commissioned Name <br /> <br />Personally Known OR Produced Identification ~ <br />Type of Identification Produced dVi-VfY'~ \\'ClMSe- <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 7 <br />