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Craven Thompson
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(12-04-04) Design and Permitting Services for Intracoastal Parks
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Craven Thompson
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Last modified
5/7/2012 2:22:18 PM
Creation date
5/7/2012 2:07:07 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Prof. Archit. & Engin. Svcs. Firms Only
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 />t ) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />t ) <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 />) <br />) <br />) <br /> <br />COUNTY OF Broward <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 /> <br />By: <br /> <br />The foregoing instrument was acknowledged before me this 30th day of <br />April , 20~, by Joseph D. Handley, R.L.A. [name <br />of person], as Vice President, Planning and Landscape Architecture [type of authority], for <br />Craven Thompson & Associates, Inc. [name of party on behalf of whom instrument was <br />executed]. <br /> <br />AFFIX NOTAB~\\Slli~~f HERE: <br />..~"'~,,\C\A D. J,O~~:/~, <br />~,<)~\ 0...000 r~;I'~ <br />~ '<, .":qMSS/O,v", ~ ~ <br />.... . 0'" 2 1:." . ~. <br />~ 004,.<:3 ':6-c'n 3,<0...,~.. ~ <br />~ :~ ~ /" ~oQ ~ <br />=* : 57 (j): :: <br />~:z: OQ~ :*:; <br />::; 0," #DD 942281 .. ~ 2:' <br />~ ~ . 'k 0 ~ ..... <br />~~;"~1- ~~ded \\"I1'>."",,,{o."r!f.. g:: <br />~ 'ou'" "blJcUnde\'~.. <.:V ," <br />;t'''"llllIG, 'ST A 1~ q\;.i~:>' <br />1111//'11111\\\\\ ' <br />Personally Known'; OR Produced Identification <br /> <br />Type of Identification Produced <br /> <br /> <br />fNq~ Ie IA- t), J~C!Z. <br />Print or Type Commissioned Name <br /> <br />DECEMBER 28, 2010 <br /> <br />7 of 7 <br /> <br />7112 <br />
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