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SV„N',stef <br /> ANTI — KICKBACK <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> ''9;. Sunny Isles Beach,FL 33160 <br /> o, sus'�o Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Dade ) <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 P-Or day of <br /> , 20 _, by GtrvJ 1 [name <br /> of person], ag [type of authority], for <br /> C� - e c02- - c ..re[name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: , <br /> A <br /> ;.�""'': ;.; NINI J SUAREZ airy Pub —4146ofFlorida <br /> MY COMMISSION#FF958965 <br /> & EXPIRES April 14.2020 N V% Sk • - <br /> 14C7iair 53 nandillftivyStrvicw.,;0,,. Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 7 of 10 <br />