Laserfiche WebLink
I FORMS + ATTACHMENTS© <br /> Professional Architecture Services for Government Center Lobby+ Gateway Park <br /> 91VNNY'/S4f,. <br /> o�: 3:,: ANTI - KICKBACK <br /> h 7. <br /> V <br /> , '� City of Sunny Isles Beach <br /> ' �• 18070 Collins Avenue <br /> '‘.,.'':7;, <br /> t.D9�}',fIOP)O �`' Sunny Isles Beach,FL 33160 <br /> `i'' .):,SUN.'NC Telephone:(305)947-0606 Fax:(305)949-3113 <br /> 1 ANTI—KICKBACK AFFIDAVIT <br /> ISTATE OF FLORIDA ) <br /> ) <br /> ICOUNTY OF MIAMI DADE ) <br /> I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br /> I 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 /> I <br /> Title: Youn Song, President <br /> The foregoing instrument was acknowledged before me this 8 day of <br /> January , 20 18 , by Young Song [name <br /> I of person], as President [type of authority], for <br /> Song+Associates, Inc. [name of party on behalf of whom instrument was <br /> executed]. <br /> IAFFIX NOTARY STAMP HERE: le. <br /> `2Q�PV'PUB Perry Douglass Notary P •lic— '•to of Florida <br /> _ : ,., '`...: Commission FF987812 <br /> 11`,.'..)-1..4i Expires: May 1, 2020 ovCe� <br /> % FYV Bonded thru Aaron Notary Print or Type Commissioned Name <br /> Personally Known X. OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> 1 <br /> I <br /> 7 of 7 <br /> SONG + ASSOCIATES 75 <br />