My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
Nextaff
SIBFL
>
City Clerk
>
Bids-RFQ-RFP
>
ITB
>
(11-05-03) School Crossing Guard Services
>
Responses
>
Nextaff
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/26/2011 11:33:54 AM
Creation date
5/26/2011 11:33:49 AM
Metadata
Fields
Template:
CityClerk-Bids_RFP_RFQ
Project Name
School Crossing Guard Services
Bid No. (xx-xx-xx)
11-05-03
Project Type (Bid, RFP, RFQ)
Bid
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
15
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
<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 />
The URL can be used to link to this page
Your browser does not support the video tag.