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O� SVNNY /S�Ff <br />x �F <br />� n <br />VI = <br />yf1 -- f "4 Op�OP Sit <br />0 <br />c�r� or suN ra <br />STATE OF FLORIDA ) <br />COUNTY OF c>z�/f) <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 elect d officials as a <br />commission, kickback, reward or gift, directly or indirectly by me or any me' <br />of my firm or <br />by an officer of the corporation. , <br />0 <br />Title:�� <br />The foregoing instrument was acknow d ed before me this o_3_ day of <br />2 l ,,� y r' r 2-2010 [name <br />o rson �asro [type of authority], for <br />[name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />•T ` ppy p <br />LAURA GUTIERREZ <br />MV COMMISSION # DD 819615 <br />EXPIRES: September 3, 2012 <br />Bonded Thru Notary public underwriters <br />A A t4l. 4- <br />Notary Public – State of Flo <br />Print or Type Commissioned Name <br />Personally Known _. /— OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />7of10 <br />