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•'ly 5)�i fs <br />9 <br />u = <br />STATE OF FLORIDA ) <br />COUNTY OF qA(,P ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 CoWns Avenue <br />sunny Isles Beach, FL 33160 <br />Telephone: (305) 947 -0606 Fa)c (305) 949 -3113 <br />ANTI - KICKBACK AFFIDAVIT <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 />The foregoing <br />of person], as _ <br />executed]. <br />By. TULfi�j <br />Title: <br />instrument was acknowledged before me this 6-1 day of <br />20-L__, by [name <br />AFFDC NOTARY STAMP HERE: <br />,ASauaweRI'm <br />-.. .: <br />W GOWASSION # DD 992109 <br />EXPIRES: June 13, 2014 <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />Notary #0b j ,— State of Florida <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEM6ER 28, 2010 <br />7of7 <br />2 L. <br />