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SUNNY 1f<F <br />t isV;. _ <br />r <br />l�)9. tiwr <br />n�rr of $U tic�o <br />STATE OF FLORIDA ) <br />COUNTY OF A Lm <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. A <br />By: p y -e .� <br />Title: 6-c-, , Q_,r-ak __ /A_6 <br />t� <br />The foregoing instrument was acknowledged before me this day of <br />20 2. by c'�� �L tK C' f [name <br />of pe son as /�� [type of authority], for <br />_._ <br />[name of party on ` behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />-0 {AMY pf" Notary Public State o � <br />2` ; Michael Sinclair da <br />o� My Commission DD893039 <br />for ncs�� Expires 06/22/2013 <br />Notary Publ' — State of Florida <br />Print or Type Commissioned Name <br />Personally Known _ OR Produced Identification Type of of Identification Produced V C- ­ I- -- <br />DECEMBER 28, 2010 7 of 7 <br />