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SV 4NY is,F _ . <br /> °,`i� "cafe - - ANTI - KICKBACK - - - • <br /> ` F <br /> 7 <br /> • '-;-4:-;4.:--- • City of Sunny Isles Beach <br /> ® `�=1�—` T' 18070 Collins Avenue <br /> �f'99'. oPsooSunny Isles Beach,FL 33160 <br /> r,o, sus '`' Telephone:(305)947-0606 Fax:(305)949-3113 _ <br /> . - - AMU-KICKBACK AFFYDAVXT • - - • <br /> . -STATE OF FLORIDA" ) " - _ <br /> COUNTY Om Qq <br /> F Mlc d� <br /> ) <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: Cigbriefi€ "fil'ic i <br /> Title: ?rtS i lir- <br /> ® The foregoing instrument was acknowledged before me this "day of <br /> /4d ' y , 20 /' by .A..-4_ [name . <br /> of person],/ as /..:_ ..11.112111W7- <br /> W= ' [type of authority], for <br /> •Z7 [ ame of party on behalf of whom_ instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> . IIVI ; <br /> - Nol Public— SlAce of Florida <br /> ere-% HASHATH MORALES <br /> .w'; MY COMMISSION N FF977061 `- y� <br /> �a EXPIRES:March 30.2020 WGt V, OA D Lia e! <br /> Print or Type Commissioned Name <br /> v ------.7. <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced ,��./„.- , ,8 .r 24;:e -74,`Jr 40 ��>._ <br /> all . . <br /> 7of10 <br />