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NhlY i. <br />F•; �.r <br />i� <br />if v91;.`fIUP�O y�e <br />C, rr QF Si1N t <br />STATE OF FLORIDA ) <br />COUNTY OF PGSCO ) <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 />By: C <br />Title: <br />The foregoing instrument was acknowledged before me this �i.� day of <br />r ' G , 20 12- , by by on [name <br />of person', as i�Vf�a( �� [type of authority], for <br />(�ES Deet [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />_ ! AMY MICHELLE NAYLOR fir at of Florida <br />=* ": MY COMMISSION # EE021402 <br />EXPIRES August 26, 2014 t/l�n ` , ;, � N -1 I Y W ( i <br />(407)398 -0153 FlcridallotaryS ^�vlco.com <br />Print or Type Commissioned Name <br />Personally Known TC OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 7 <br />