Laserfiche WebLink
<br />) <br /> <br />" <br />, <br /> <br />) <br />) <br />) <br />) <br />} <br /> <br />\ <br />, <br /> <br />) <br />) <br />) <br />) <br />) <br />n ) <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 Miami-Dade ) <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 mem(:Jf my firm or <br />by an officer of the corporation. <br /> <br /> <br />"'~ <br /> <br />By: <br /> <br /> <br />Carlos H. Perez, PE <br /> <br />Title: President <br /> <br />The foregoing instrument <br />December, 2011 , 20_, by <br />of ~' as President <br />t\ " ~9 ~<;;JCA~ <br />executed] . <br /> <br />was acknowledged before me this <br />Carlos H. Perez, PE <br /> <br />1 st <br /> <br />[name of party on <br /> <br />day of <br />[name <br />[type of authority], for <br />behalf of whom instrument was <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />,'''''' M' L hl d <br />~'-;'~Y.t:~~,,__ ana aonor 1'1 en es <br />ff~/A"~ -; COMMISS!OI1 # DD957786 <br />=~. .",- <br />~,:i ...' Cl~~} EXPIRES: FEB. 02,2014 <br />"'I,?,;,:;;,," WWW.MRONNoTARY.com <br /> <br />Personally Known ~ OR Produced Identification V <br />Type of Identification Produced r 7)rc:ve..- U ~5e <br /> <br />DECEMBER 28,2010 <br /> <br />7 of 7 <br />