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) <br />) <br />) <br />) <br />) <br /> <br />I ) <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 />or svt-l <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 m or any member of my firm or <br />by an officer of the corporation. <br /> <br />By: <br /> <br /> <br />Title: President <br /> <br />)... The foregoing instrument was ackno~ledged before me t~is } SI- day of <br />V<2cemb-erL , 20--1.L, by tIlrJ-f-DN/O &r, b4{OS~1 P. C: . [name <br />of per;;qq], ,as ~n.fs"d(7(\)t- [type of authority], for <br />f) arvel r f!orv-swl N(j [name of party on behalf of whom instrument was <br />executed] . <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />J:~' f ~ <br />N ry Public - Sta 0 Florida <br /> <br />J u I ('C{ r; I 86L/Cc <br />Print or Type Commissioned Name <br /> <br />\'''''''' J ,. E 8 <br />~,t~Y.f'dt'-.. U 18 . I oyce <br />i~':&"~~ COMMISSION # EE088121 <br />-~. .~- . <br />\~~.... ~iEXPIRES: FEB. 09,2014 <br />"'"ff..~,\" WWW.AARONNOTARY.com <br /> <br />Personally Known OR Produced Identifica~ion t/ <br />Type of Identification Produced r:::-L ])(//I/eJ2S LiceN~ <br /> <br />DECElABER 28, 2010 <br /> <br />7 of 7 <br />