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OT 4VNNT ,,,F+S <br /> ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> 18070 Corms Avenue <br /> i o"o + Sunny Isles Beach.FL 33160 <br /> Telephone:(305)947-0606 Fax (305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Palm Beach ) <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. C <br /> By: / _err <br /> Title: Vice Pre•. . nt <br /> The foregoing instrument was acknowledged before me this I I b" day of <br /> December , 2012 , by (�I��iarr �Il�ct� [name <br /> of person], as Vice President [type of authority], for <br /> Sports Turf One, Inc. [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: /A`A <br /> eu Notary Public State of F lone a otary P Ec— State of Florida <br /> Lauren M Barnes <br /> A i, My Commission EE 846604 Lauren M. Barnes <br /> o A Expires 10/25/2016 <br /> Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> DELFI®ER 28.2010 7 of 10 <br />