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Titan Protective Services Proposal to Provide Pier Park Attendant RFP No. 18-03-01 <br /> , $KV+s�F <br /> O� ;s.�' \fin <br /> ANTI - KICKBACK <br /> i' _ <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> s� °'•r oa' + Sunny Isles Beach,FL 33160 <br /> C'f'>o, sUO'ro Telephone:(305)947-0606 Fax(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> //�� <br /> COUNTY OF [)Ac- ) <br /> 1, 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 mem.:r of my firm or <br /> by an officer of the corporation. <br /> By: <br /> Title: <br /> The foregoing instrument was, acknow edged before me this 2 LI day of <br /> Floc �, , 2 iT, by Kcwil' /ii�i�i� y [name <br /> of person , as Pres/d�,t---- ' [type of authority], for <br /> 714-an �iiri-eed-flre, Seiv►-s J c [name of parry on behalf of whom instrument was <br /> executed]. <br /> AmEIX_NOTARY STAMP HERE:? <br /> _otary-Public?State-of-Florida <br /> ;<.o!e ;• RODLIN CHARLES ' <br /> ;.; }.; MY COMMISSION I GO 155088 <br /> �" EXPIRES <br /> erlitsv• <br /> :October 28.2021 <br /> '. e,fi'p. Bonded ThruNotary POW Undentrtfters Print or Type Commissioned Name <br /> Personally Known OR Produc d Identification <br /> Type of Identification Produced 01- bZS-1-Sl`-f 03) - <br /> 7 <br /> 3) -7 of 7 Page 171 <br />