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C NT,Ji ex <br /> • 71ANTI - KICKBACK <br /> '` ���� City of Sunny Isles Beach <br /> %per 18070 Collins Avenue <br /> fiO"� o`` Sunny Isles Beach.FL 33160 <br /> r`c, .o+�" Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF 16=- ) <br /> ) <br /> COUNTY OF Comp Eck ) <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: /.--e/7/-----___ <br /> Title: (2•gip <br /> The foregoing instrument was acknowledged before me this 4-Zvs day of <br /> triqati , 20 1 ?, by --Sobv. SG1va t [name <br /> of persbn], as c;4- cmo—c;a` a ,a,,.-- [type of authority], for <br /> Sew--k— 4<k 1 7�G [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> Notary Public— State of ' eAsc' <br /> 57 L /1 /57--46( <br /> Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> NOTARY PUBUC <br /> Type of Identification Produced Kentucky,State At Large <br /> 1.0.0 543108 <br /> My Commission on Wks 101712019 <br /> 7 of 7 <br /> Q. <br /> 7 .J <br />