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SONNY is, <br /> ° . :-'-N ,610 ANTI - KICKBACK <br /> . <br /> City of Sunny Isles Beach <br /> 1/4__ ' 18070 Collins Avenue <br /> Sunny Isles Beach,FL 33160 <br /> cs'''0, ,uo '"° Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF Mt.M I -006 ) <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. <br /> By: <br /> Title: S- i' <br /> /� The foregoing instrument wasacknowledged Abefore me this al��� day of <br /> 19I,'o\1— , 20 )g , by C r(�S iso Ck�_1Q7.> [name <br /> of person], as P(l.c( UP Q P'PQ-ic-\QR — [type of authority], for <br /> -1 `aY1 -\I1•eV'V [name of party on behalf of whom instrument was <br /> executed'. <br /> AFFIX NOTARY STAMP HERE: • 1 <br /> ' • ary Publ' — Sta a of Florida <br /> hob: WISANGEU.IMENEZ <br /> + MY COMMISSION 0 FF 913313 �, �p �.� <br /> .%�: ,a EXPIRES:August�.2019 Liii I aV\ k-) J I•( M e--- <br /> ',4,,iiF iz Bonded Thru Notary Bulge Underwriters <br /> Print or Type C mmissioned Name <br /> Personally Known `/ OR Produced Identification <br /> Type of Identification Produced <br /> 7 of 10 <br />