Laserfiche WebLink
<br />I <br />1 <br />I <br />" <br />~ I - - <br />F 1 <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~KICKBACKAFEIDA VIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF ,!)A h <br /> <br />) <br />) <br />) <br /> <br />i <br />'I <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 indirectly by me or any member of my firm or <br />by an officer of the corporation. \\, <br /> <br /> <br />By: ~ <br />Title: PAl';' d:r d 7 <br /> <br /> <br /> <br />ed bef}lre me this 07 day of <br />~ 'ia-/'~ ,;!}. [name <br />[type of authority], for <br />behalf of whom instrument was <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Personally Known ~ OR Produced Identification <br />Type of Identification Produced <br /> <br />State <br /> <br />'~O~:f) . <br />Print or Type COrr1m~~~~S!,~me <br />.~'''J': \; 1TE OF FT,orrmA <br />/" ' \. Laura A Gonzaler. <br />~ j CO!~mission t/ DD842247 <br />'",,,....,.. Expires: DEC. 0.5, 201? <br />nONllRn 1'Htw Al'LhNTIC DONDInG co,.lNC: <br /> <br />DECEMBER 28, 2010 <br /> <br />7of7 <br />