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0 <br /> ® SVr1NY ISFJ <br /> = h� ANTI - KICKBACK <br /> ® V ,Cit of SunnyIsles Beach <br /> •.. Y <br /> ® �•'c 9= oo• 18070 Collins Avenue <br /> Se •ss.oR � Sunny Isles Beach,FL 33160 <br /> ® 'r o, sus' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> ® STATE OF FLORIDA ) <br /> COUNTY OF ) <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: . -r <br /> -w <br /> • <br /> ® Title: <br /> rd <br /> The foregoing instrument was acknowledged before me this ,3 day of <br /> X O\Jeil llaefz , 20 i1 , bySeG�r) Luks t acc) \ 1 Lt [name <br /> of person , as [type of authority], for <br /> S m .a onau 0 S A [name of party on behalf of whom instrument was <br /> execed]. <br /> ® AFFIX NOTARY STAMP HERE: <br /> ® J-41__ / <br /> ® , µ11i%4; NushleyNoel 'Notary PublicState of Florida <br /> ® l! = Commission#GG117214 '`I u S M <br /> Expires:June 21,2021 0� L <br /> ® ';;ZIA Bonded thru Aaron Notary Print or Type Cdrnmissioned Name <br /> ® Personally Known OR Produced Identification <br /> ® Type of Identification Produced A.- t (x \Ct l0. 1 • <br /> 0 <br /> 70(7 <br /> S <br /> S <br />