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<br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />J ._J <br />! ) <br />I } <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />} <br /> <br />\ <br />, <br /> <br />) <br /> <br /> <br />or 'pl?- <br /> <br />STATE OF FLORIDA <br /> <br />-p~ <br /> <br />COUNTY OF <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 />) <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 />The foregoing <br />~ , <br />of person], as <br />L\vS I\-sso~ <br />executed] . <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />.,.~'?o;.Y.~~,,<{, IRALDY MARTIN <br />. " MY COMMISSION # DD 968426 <br />.. '" <br />EXPIRES: March 7, 2014 <br />"-':.;~OOFf\.O<i'<:''' B<lnded Thru Budget Notary Services <br /> <br />By: <br /> <br />T. ~~lO RosM <br />1'(~ {\.~ <br /> <br />Title: <br /> <br />30 day of <br />[name <br />[type of authority], for <br />behalf of whom instrument was <br /> <br /> <br />Notary Public <br /> <br />--r V""cc \.~ ~r -h Vl <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 />