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I0,SVsNy ke,cc <br /> � <br /> ;, ANTI - KICKBACK <br /> • <br /> City of Sunny Isles Beach <br /> y 18070 Collins Avenue <br /> • x '�r,00 ^ Sunny Isles Beach,FL 33160 <br /> ITelephone:(305)947-0606 Fax (305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> I <br /> NEW YORK <br /> STATE OF MORIN( ) <br /> COUNTY OF ONONDAGA ) <br /> II, 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 /> I 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 /> 3 , iCto <br /> I <br /> By: � � - r <br /> ITitle: Vice-President <br /> IThe foregoing instrument was acknowledged before me this 5 day of <br /> 7). ec, 20 /a , by tJ/cc'4m J. %NU.R-,-O [name <br /> I of person], as Vice- Pies . [type of authority], for <br /> 6/11-1.42-1) ( ,gsreuc na,v Ivr [name of party on behalf of whom instrument was <br /> executed]. <br /> IAFFIX NOTARY STAMP HERE: J� e ( 1 <br /> Notary Public —State o N�Wy�� <br /> Notary Public in the State of Naw York <br /> Qualified in Cayuga County No 4670472 / <br /> My Commission Expires March 30,20/L,.. Y LO ACE-✓ t t-CI Print or Type Commissioned Name <br /> IPersonally Known ✓ OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> IOECEL ER 28,2010 7 of 10 <br />