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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 />) <br />COUNTY or"B~ ) <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: f l~' <br />/ i./' <br />TItle: " ,q,-u.S1\ j-b:u.~ <br /> <br /> <br />The foregoing instrument was acknowledged before me this <br />\l\o....~ , 20-.lL, by <br />person], \ as <br /> <br />!):pj; day of <br />[name <br />[type of authority], for <br />behalf of whom instrument was <br /> <br />"""~'~"'. <br />'-"<!l","-..~. MYRTI.ECORBIN <br />f*~ "iE.' i*~ MY COMMISSION # DO 932672 <br />~~~$~ BooEXPIRES: October 28,2013 <br />:'!!/"r,i.. ded Thru Notary Public Undenwiters <br /> <br />~~~~ Q <br />Notary Pub ic - State of Florida <br /> <br />" <br />-- <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br /> <br />Personally Know OR Produced Identification <br />Type 0 entification Produced N'bh~ <br /> <br />DECEMBER 28, 2010 <br /> <br />? of? <br />