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(12-06-01) Construction Management for Gateway Park
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Last modified
6/14/2012 2:20:54 PM
Creation date
6/14/2012 2:13:14 PM
Metadata
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Construction Management Svcs for Gateway Park
Bid No. (xx-xx-xx)
12-06-01
Project Type (Bid, RFP, RFQ)
RFQ
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i <br />SVNNY ls�', <br />� <br />ANTI- KICKBACK <br />City of Sunny Isles Beach <br />�• 18070 Collins Avenue <br />�sF '9) F doe ° sir Sunny Isles Beach, FL 33160 <br />o'r oe su++'Na Telephone: (305) 947 -0606 Fax: (305) 949 -3113 <br />ANTI - KICKBACK AFFIDAVIT <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <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: <br />Title: President <br />The foregoing instrument was acknowledged before me this 12 day of <br />June , 20 12 , by Jose A. Gonzalez [name <br />of person], as President [type of authority], for <br />CIMA Engineering Corp. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Y'a$ VMANA VINDEL <br />: *, r MY COMMISSION # EE 137264 <br />a., EXPIRES: October 11, 2015 <br />, • tiyffi Bonded Thru Notary Public Underwriters <br />k— State of Florida <br />Viviana Vindel <br />Print or Type Commissioned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced <br />u DECEMBER 28, 2010 7 of 7 <br />
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