Laserfiche WebLink
<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 dbdQ., <br /> <br />) <br />) <br />) <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 /> <br />Title: <br /> <br />1 I The foregoing instrument was acknowledged before me this '3/ day of <br />uAl( , 20-.lL, by ~AeL- ~lLVA [name <br />of person], as "-tAt0 o.GElZ- [type of authority], for <br />OAI-t\~ Co~-t~cT\0t0 Cb~ c.... [name of party on behalf of whom instrument was <br />executed] . <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Print or Type Commissioned Name <br /> <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 10 <br /> <br />~r <br /> <br />~\) ,AM-I IV CCf0'& 't(2~i( 0 ,j <br /> <br />17r:::> , I .. ~;::- __ J <br />