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s sy Fib �9*•,,�.�` <br />m �'Tr of sua n�,v <br />STATE OF FLORIDA- <br />) <br />COUNTY OF Lam' A, ��( <br />ANTI - KICKBACK <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 />ANTI - KICKBACK AFFIDAVIT <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 />Title: pirecior of ar�teZ <br />he foregoing instrument was <br />I /�A? G , 20 1 f by - <br />of person], as i cece � I <br />executed]. M06 <br />AFFIX NOTARY STAMP HERE: <br />DONG GUYN KIM <br />Commission # 1805718 <br />Notary Public - California z <br />' Los Angeles County <br />My Comm. Expires Jul 30, 2012 <br />Jged before me this <br />Y" �Gtn k >°yt "I n s�: — [type of <br />[name of party on behalf of whom <br />f <br />day of <br />[name <br />authority], for <br />instrument was <br />t , Notary Public . State of Ver -ida -- <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification �! <br />Type of Identification Produced L:I k2 L, <br />DECEMBER 28, 2010 7 of 7 <br />