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<br /> <br />ANTI-KICKBACK <br /> <br /><>f ~ J t4 <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 />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 />~ 'J:JiS <br />Lt,t[ Cj1r~J rfI);u- <br /> <br />The foregoing instrument was acknowledged before me this 'I -Ul day of <br />~ Wnl cuy , 20lL, by T(,uk Ge..rvQ\,; [name <br />of person], as ~\'\(cc 01lLNt.'li-{\~ O.c..c.-U_I [type of authority], for <br />WJ L()(? d-b.L~ CbrUphPl€.lG S>ro@"-s [n me of party on behalf of whom instrument was <br />executed] . <br /> <br /> <br />By. <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />i~J...-:r.~'ftiif:, VICKIE L HEROlD <br />i*/:''K~ :*E MY COMMISSION ~ EE 082114 <br />~'~':Q'.? EXPIRES: April 10, 2015 <br />---7f,iif.'/;;*'" Bonded Thru Notary Public Underwriters <br /> <br />'(l~U0..L ~, 'I*~ <br />Notary Public - State of Florida <br /> <br />\/i cL-( L. I--t€-(o(~ <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 />