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<br />. <br />~ <br />~ <br />:J <br />. <br />.. <br />'t <br />. <br />') <br />. <br />. <br />. <br />. <br /> <br />" <br />. <br />-... <br />. <br /> <br />- <br />~ <br />...... <br />.. <br />- <br />~ <br />-... <br />~ <br />- <br />., <br />....... <br />~ <br />..... <br />~ <br /> <br />. <br /> <br />- <br />~ <br />- <br />. <br /> <br />~ <br />. <br />~ <br />') <br />~ <br />'t <br />~ <br />'l <br />-. <br />... <br />~ <br />, <br />~ <br />, <br />l <br />) <br />1 <br />l <br /> <br />- <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 />Of $ut-l <br /> <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA <br /> <br />) <br />) <br />) <br /> <br />COUNTY OF Broward <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br />will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a <br />commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or <br />by an officer of the corporation. <br /> <br />By: <br /> <br />Dennis J. Gior[L~ <br /> <br />Title: President <br /> <br />\ Tt)!' foregoing instrument ''f\s acknovylediled before me this ~ day of <br />~ \.l...~ lJ\ , 20J.,L, by,,- 'lml"- \.~IC\yAcLlt() [name <br />of perso],' ), ~ ' Q (\.-t' [type of authority], for <br />( ~ _ ~ oC-. [name of party on behalf of whom instrument was <br /> <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />,'1 J:\ <br />Notary Public - tate of Florida <br /> <br />)y, uj() #D(( ((l'\ <br />Print o.r Type Commi'ssioned Name <br /> <br /> <br />",'U'" <br />$~~~Y pu;z.", DAWN HOPKINS <br />i ~ · ".c'; Notary Public. State of Florida <br />~~ .;j My Comm. Expires Feb 18. 2013 <br />~,. fj,:- <br />"~:;~ 0< ,.(f,--- Commission 1# DO 862678 <br />I"U"" <br /> <br />Personally Known V OR Produced Identification <br />Type of Identification Proauced <br /> <br />DECEMBER 28,2010 <br /> <br />70f7 <br />