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<br /> <br />ANTI-KICKBACK <br /> <br />Or :t >,":,- <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 Dade <br /> <br />) <br />) <br />) <br /> <br />If the undersignedf 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 />commissionf kickbackf 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 />BreI T. Brittenum <br /> <br />,~ ~~'/ <br />/1 ,;/~/ ~//-=.: <br />~<. /.~- <br /> <br />--- ----- <br /> <br />Title: Vice President & General Manager <br /> <br />The foregoing instrument was acknowledged <br />l-{{/-, f 20~f by Bret T. Brittenum <br />of persont as Vice President & General Manager <br />American Coach Lines of Miami, Inc. <br /> <br />before me this <br /> <br />day of <br />[name <br />[type of authorityl for <br />behalf of whom instrument vI/as <br /> <br />7<. :- <br /> <br />[name of party on <br /> <br />executed] , <br /> <br />.-- <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />/ <br />/ <br /> <br />NOTARY P'"LJBUC-S'l'A'I'E OF FLORIDA <br />~<"'"::''' Jecic Molina <br />~ ~# J Co~mission #DD87661S <br />....,",...'~ Expll'es: JULY 07, 2013 <br />BON DED THRU ATLANTIC BONDING CO., me. <br /> <br />J/c_ ,/ '--~ ~ <br />....<...-. ./ <br />\---NOtary Public - State of Florida <br />/ / <br />./ '- .--- <br />// <br />../ <br /> <br />, <br />/ <br /> <br />-( {; / <br /> <br />/ , <br />/'--;'"1 ~ V ~ <br />- '--' , <br /> <br />Print or Type Commissioned Name <br /> <br />Personally Known / OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28,2010 <br /> <br />7 of 7 <br />