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Craven Thompson & Assoc.
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(11-11-02) Civil Engineering Services to Design Street & Drainage Improvements
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Craven Thompson & Assoc.
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Last modified
2/9/2012 3:31:13 PM
Creation date
2/9/2012 3:27:24 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Civil Engineering Svcs
Bid No. (xx-xx-xx)
11-11-02
Project Type (Bid, RFP, RFQ)
RFQ
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<br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <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 />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 />Title: <br /> <br />'" <br />/' obert D. Cole, III, P.E., LEED AP, NO <br />Executive Vice President <br /> <br />The foregoing instrument was acknowledged before me this 1 st day of <br />December , 20.1L, by Robert D. Cole, III, P.E., LEED AP, ND [name <br />of person], as Executive Vice President [type of authority], for <br />Craven Thompson & Associates, Inc, [name of party on behalf of whom instrument was <br />executed] . <br /> <br />AFFIX ~~~~~:~fg~.HERE: <br />~ <<~o:~~ISSION ~'~f'<<'''~ <br />" 0 G'" 23 'I"" 0 ~. <br />~ .. C3 ~c\\ '<0 ~.. -::. <br />~ :~~~ /", ~.. ~, <br />: . . -- <br />:*: .... :*;: <br />- . . -. <br />~ ~o~ #00942281 .: iJ g <br />~;:>'..11. {::??f2~ <br />~ ~ 0 0 o~'Y 8onde<! \'n'll>~~o" C5 ::,":. <br />~ I--Aoo!UblicUn6"ooof<~'v~' <br />~/IIP8LiC"ST~~~ ~,\\,\,~. <br />"'II" i 1111 \1\\\' <br /> <br /> <br />fA:'T~lqA 1). JoyCf.- <br />Print or Type Commissioned Name <br /> <br />Personally Known .,,/ OR Produced Identification <br />Type of Identification Produced <br /> <br />DECEMBER 28,2010 <br /> <br />7 of 7 <br /> <br />7112 <br />
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