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�J�rov ;y�F <br />s <br />+n <br />Or <u, <br />STATE OF FLORIDA FL ) <br />COUNTY OF e-jCuv1x,-q- <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 />The foregoing instrument- <br />PW , 20 % Z, by <br />persons as V—° <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />ANNFTTI ;'APPAS <br />h•,ta .:bn: Slam rinnja <br />?•,�q\ My Luwm Expires May 7b 7u i <br />rf'!nmrssion # EE 78895 <br />By: <br />Title: <br />vice President 1 SS <br />n <br />G�g <br />"'t w'-0 t7 <br />acknow ed before me this -Z-7 day of <br />p &5 [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />- 1 <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />7of7 <br />34 <br />