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O� SuNNY ,S�FJ' @. <br />l F <br />� n <br />P <br />yf '99 �a� FIOP�O y,�t <br />Carr or SUN FNv <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -Dade ) <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 />HE <br />Title: - -Juan S. Calderon, PE- Vice President <br />The foregoing instrument was acknowledged b f re me this day of <br />0 , 20–L-& by f ® [name <br />of pers , as `S'(\ \v � [type of authority], for <br />Fname of Dartv on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Marfdrle Pee;rlr. Hernandez <br />FEB, 28, 2016 <br />�lrikONN07ARY.com <br />Notary Public – Sta a of Flori -� <br />o� �� \A( <br />Print Type Commissioned Name <br />Personally Known OR Produced Identification _ <br />Type of Identification Produced .— <br />DECEMBER 28, 2010 7 of 7 <br />