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(12-04-01) Professional Architectural and Engin. Svcs - Individulas Only CCNA
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Last modified
6/12/2012 11:43:43 AM
Creation date
6/12/2012 11:38:46 AM
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CityClerk-Bids_RFP_RFQ
Project Name
Prof. Architectural & Engineering Svcs - Individuals
Bid No. (xx-xx-xx)
12-04-01
Project Type (Bid, RFP, RFQ)
RFQ
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Sty ;NY !S(R <br />4; t� <br />7. <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <br />ANTI - KICKBACK <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 />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 />By: Alz_� <br />Title: President <br />The foregoing instrument was acknowledged before me this c2S-" day of <br />A pelf L. , 20 / J__,, by Michael R. Fawley [name <br />of person], as President [type of authority], for <br />Sun -Tech Engineering, Inc. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NgTARY,5,TAMP HERE: <br />0611312014 <br />NOTARY PUBLIC <br />Commission # <br />Nj •.DD982186. •' , <br />OF F <br />Personally iftA <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />Notary Public — State Florida <br />A, LAEC nl ) wW yu2 <br />Print or Type Commissioned Name <br />OR Produced Identification <br />32 <br />
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