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soNY 1st et <br /> ~�..� ANTI - KICKBACK <br /> V I <br /> City of Sunny Isles Beach <br /> • t_ `' • 18070 Collins Avenue <br /> •v1.Ops + Sunny Isles Beach,FL 33160 <br /> 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: Allan Alcerro <br /> Title: Store Manager <br /> • The foregoing instrument was acknowledged before me this 05 day of <br /> September , 20 17 , by Allan alcerro [name <br /> of person], as Store Manger [type of authority], for <br /> The Goodyear Tire & Rubber Company [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> Notary Public — State of Florida <br /> Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> 7 of 7 <br />