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RFP No. 11-05-01 Bella Vista Bay Park Improvements
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Lynx
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Last modified
6/17/2011 2:19:02 PM
Creation date
6/17/2011 2:18:35 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Bella Vista Park Improv.
Bid No. (xx-xx-xx)
11-05-05
Project Type (Bid, RFP, RFQ)
RFP
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<br /> <br />ANTI-KICKBACK <br /> <br />OF S.Ut-l <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 OF Miami-Dade ) <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 b me or any member of my firm or <br />by an officer of the corporation. <br /> <br />" <br /> <br />By: <br /> <br /> <br />Title: President <br /> <br />The foregoing instrument <br />May , 20~, by <br />of person], as President <br />Lynx Construction Management, LLC <br /> <br />was acknowledged before <br />Christopher Moran <br /> <br />me <br /> <br />this <br /> <br />31 <br /> <br />[name of party <br /> <br /> <br />day of <br />[name <br />pe of authority], for <br />eh If f whom instrument was <br /> <br />executed]. <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />R""'~Y ~1I~ <br />. . <br />"'-c. 3 <br />~?'. 04' <br />Orf\': <br /> <br />Notary Public State 01 Florid. <br />Ariel Diaz <br />My Commission EE071467 <br />Expires 0510412015 <br /> <br />Personally Known ~ Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 10 <br />
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