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<br />'J <br /> <br /> <br />STATE OF FLORIDA ) <br />) <br />COUNTY OF Miami-Dade) <br /> <br />~E (og <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 />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 />" <br />) <br /> <br />By: <br /> <br />R. Harvey sas~ <br /> <br />President <br /> <br />Title: <br /> <br />The foregoing instrument was acknowledged before me this <br />December , 20~, by <br /> <br />of <br /> <br />person], <br /> <br />as <br /> <br />1 <br /> <br />day of <br />[name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br /> <br /> <br />~c~~i~ <br /> <br />V (){l (~~ fA- Ri;f>S: fvf~J,.Jo <br />Print or Type Commissioned Name <br /> <br />executed]. <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />G..., "Vq <br />~o v,.. <br />',) ; <br />"~ '- t. ,f <br />s J)o O;,\,O <br /><.,..; <br /> <br />Notary Public State of Florida <br />Vanessa Russi-Machado <br />My Commission EE017222 <br />Expires 10/14/2014 <br /> <br />Personally Known /. OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28, 2010 <br /> <br />70f7 <br />