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<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 />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />) <br />COUNTY OF Broward ) <br /> <br />1 <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 /> <br />Peter Moore,P.E., LEED AP <br /> <br />Title: <br /> <br />President <br /> <br />The foregoing instrument <br />December , 20-.lL, by <br />of person], as President <br />Chen Moore and Associates <br />executed]. <br /> <br />was acknowledged before me this 2:.-- day of <br />Peter Moore, P.E., LEED AP [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br /> <br />NOTARY PUBLIC.STATE OF FLORIDA <br />~~,'Ulr',#,~ Leigh Barron <br />~ ~ j Co~mission II EE098032 <br />....""...... Expires: JUNE 06, 2015 <br />BONDED THRU ATLA.\iIC RONDING CO., INC. <br /> <br />(; <br />;j~,-:r_r"_, ~ <br />Notary Public - State of Florida <br /> <br />\.e..:-~ (;l:,Vr'<;r' <br />Print or . ype Commissioned Name. <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Personally Known x OR Produced Identification <br />Type of Identification Produced <br /> <br />CU.:E <br /> <br /> <br />&ASSOClAlI'S <br /> <br />7 of 7 <br /> <br />/lro ;\'o.//-II'(}l til'il J:lIljilll'l'rilllj Serl'irl's 10 f)1'Siljll .II/HI 1I11t! f)ra;II(1lje IIII{lflIl'I'lI/enIS <br /> <br />7.11 <br />