Laserfiche WebLink
SUNNY/S(e <br /> ANTI - KICKBACK <br /> v — x <br /> •• City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> •v Pia + Sunny Isles Beach,FL 33160 <br /> or su• ' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF �L4-( d( ) <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: C2���--� <br /> Title: Z7~,e4' <br /> 111 The foregoing instrument was acknowledged before me this 7d day of <br /> /(AY , 20 /2 , by TZ ,67an [name <br /> of pefson], as e -4. 7t7for. [type of authority], for <br /> (iis; go y_ LC Cr�6G ers [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> N e .ry Public— State of Florida <br /> ""I ?4;: KIRSTIN D IMMELL U A // <br /> MY COMMISSION# i'11 ,5 r(} 1 'crime"' <br /> '•? EXPIRES March 28,2021 Print or Type Commissioned Name <br /> Personally Known D` OR Produced Identification <br /> Type of Identification Produced <br /> • <br /> 7 of 7 <br />