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<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 ) <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 />Title: Av~ort>z,pj ~ <br /> <br />The foregoing instrument was acknowledged before me this L day of <br />fpAo('\ArN~ ' 20-ik-, by C;'r-^r-O\ ^J\eJj ru- [name <br />of, person', as AA-t"hC'lr\?--eB ~/Tt [type of authority], for <br />5VlS~\ I\a b Ie. ~e~ibro.:floN ,rive. . [name of party on behalf of whom instrument was <br />executed] . <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />,#\~~v~. DOUGLAS H MEt;tCADO <br />~': :.~ MY COMMISSION # EE050306 <br />-:"': ..,:: EXPIRES December 20, 2014 <br />'"I <br />(407) 398..()153 FlorldaNotaryServlce.com <br /> <br /> <br />~ <br /> <br />VlO..J~ l"\s f\A.qJ G0:Db <br />Print or ype Commissioned Name <br /> <br /> <br />Personally Known /' OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 7 <br />