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Curtis & Rogers Design
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(12-04-04) Design and Permitting Services for Intracoastal Parks
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Curtis & Rogers Design
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Last modified
5/2/2012 12:04:20 PM
Creation date
5/2/2012 11:55:49 AM
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CityClerk-Bids_RFP_RFQ
Project Name
Design and Permitting Svcs for Intracoastal Parks
Bid No. (xx-xx-xx)
12-04-04
Project Type (Bid, RFP, RFQ)
RFQ
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<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 />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, direc or directly by ~ any member of my firm or <br />by an officer of the corporation. \ \ <br /> <br /> <br />Title: <br /> <br />President <br /> <br />The foregoing instrument was acknowledged before me this 96 <br />April / 20~, by <br />of person], as <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 />executed] . <br /> <br />~v PC/8 Notary Public State of Florida <br />~ \~ <1: Vanessa Russi-Machado <br />It:, ~ My Commission EE017222 <br />~ Expires 10/14/2014 <br /> <br />,-'l..'" <br /> <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <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 />
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