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<br />c <br /> <br />c <br /> <br />c <br /> <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 />9r \u"" <br /> <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />) <br />COUNTY OF PALM BEACH ) <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 />~FjijLi r~# <br /> <br />Title: V. P., Manager of Engineering/Geotechnical <br />Design Services <br /> <br />The foregoing instrument w3 acknowledged before me this /4<!- day of <br />~ 20~, by ----1.J1 oVl'l.a.5 F M.v..11 i () [name <br />of perso], as V,'c.e:.- fr-es i e<.-e4 [type of authority], for <br />Ute~ (ocFOrl1o..t1rY\ S9-~ef'f\ [name of party on behalf of whom instrument was <br />executed]. <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br /> <br />- -- <br /> <br />~ "~~~';::;'" ~HIRLEY STARK <br />./"O[lt-' . <br />~ !<FJ \ Notary Public . State of Florida <br />,i' .'~MyComm.ExpiresMar22.2015 <br />· ...c.I'... ~~ <br />"":;'ioff'~~" Commission 1# EE 49014 <br />"".....,.. <br /> <br />~ - <br /> <br />Personally Known ~ OR Produced ~entification Nt <br />Type of Identification Produced .I'I!f3 <br /> <br />DECEMBER 28. 2010 <br /> <br />7 of 7 <br />