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I <br /> 1 <br /> NQ IS <br /> V„.)!.4!L_'is <br /> G %i..d. O- <br /> i ANTI - KICKBACK <br /> +. . City of Sunny Isles Beach <br /> o 18070 Collins Avenue <br /> I se <br /> •o r ,u Sunny Isles Beach,FL 33160 <br /> Telephone (305)947-06%Fax (305)9443113 <br /> IANTI-KICKBACK AFFIDAVIT <br /> LOUISIANA <br /> I STATE OF FIBMINA ) <br /> PARISH EAST BATON *OOGE <br /> ( OF ) <br /> 1 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 /> Icommission, kickback, reward or gift, directly or indirectly by me or any member of my firm or <br /> by an officer of the corporation. 4_,,fjt I By: -- <br /> C. Dawson <br /> iTitle: C.E.O. <br /> I The foregoing instrument was acknowledged before me this 11th day of <br /> December 2012 by Charles C. Dawson [name <br /> of person], as c.E.o. [type of authority], for <br /> I [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX'NOTARY-'STAMP HERE: ` \ <br /> I _ _110 ,� <br /> _ No - ry Public — State of l �a SIANA <br /> 1 - - <br /> Sharon C. Ragusa #039606 Lifetime Commission <br /> = Print or Type Commissioned Name <br /> I <br /> Personally Known % OR Produced Identification <br /> 1 Type of Identification Produced <br /> I <br /> I <br /> 1 DECEMBER 28.2010 7 of 10 <br />