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• <br /> 4 s,rig Y'SFl <br /> e9 ANTI - KICKBACK <br /> . n <br /> • <br /> u z <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> sr'D91•FLOW' <br /> +° Sunny Isles Beach,FL 33160 <br /> or suo'•c Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF CHARLOTTE ) <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 /> A/ • �., <br /> By: i <br /> Blaine Byers <br /> Title: Service Sales <br /> The foregoing instrument was acknowledged before me this 21st day of <br /> February , 20 17 • by Blaine Byers [name <br /> of person], as service Sales [type of authority], for <br /> Air Mechanical & Service corp[name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: / <br /> (4/. <br /> LARRY DALTON y Public — State of Florida <br /> MY COMMISSION#FF115182 <br /> ‘`'>' J• Larry Dalton <br /> i,t,0 EXPIRES June 26,2018 <br /> (4071 398-0153 FloridallotaryService.com Print or Type Commissioned Name <br /> Personally Known X OR Produced Identification NA <br /> Type of Identification Produced NA <br /> DECEMBER 28,2010 7 of 10 <br />