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<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 />COUNlY OF VAnE <br /> <br />) <br />) <br />) <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: rvl AQ..\L. '\J Aoo\'\J Q 0 <br />Title: 7re<5ld~Y'\T <br /> <br />The foregoing <br />Afif \ , <br />of person], as <br />C::Sho'("{\./C; ~ B& <br />executed]. <br /> <br />instrument was acknowledged before me this 1 ;;L. day of <br />20~, by M AR..lL V ~ 12.-0 [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br /> <br />f........ ...MARiA.SERVAT............! <br />I Comm# D00880302 i <br />i Explres 5/3112013 i <br />~ ,~". .rt:lll NotGry Assn,. Inc ~ <br />~'J ~.,,.--.,.,....- ,,.... ,'" .. .....r't.,.'!'<l~IHH...'.".. ,.' <br /> <br />C--"~"" <br /> <br />~~-....~U7U~ <br /> <br />Notary Public - State of Florida <br /> <br />H P () I fl ~<f-t.J -AT' <br />Print or Type Commissioned Name <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />Personally Known ~ OR Produced Identification <br />Type of Identifica on Produced <br /> <br />DECEMBER 28,2010 <br /> <br />7of7 <br />