Laserfiche WebLink
to, <br />STATE OF FLORIDA ) <br />COUNTY OF ORANGE ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />1 B070 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' Mike Spruce /P.E. <br />Title: Principal -in- Charge /Vice President <br />The foregoing instrument was acknowledged before me this 1st day of <br />December 2011, by Mike Spruce, P.E. [name of person], <br />as Principal -in- Charge /Vice President [type of authority], for <br />Kimley -Horn and Associates, Inc. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />=oogY'oa<1 Notary Puolic State of Flcca.2 Notary Public — State of Florida <br />Marcia A Lornelison <br />Yfl'o_ia My COR1rn15Sion DD9onuC6 £xp�res 0911 112013 I <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 26. 2010 7 of 7 <br />