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• <br /> �soo NY.IS(EJ - <br /> �,. a <br /> a'. <br /> ANTI - KICKBACK <br /> A ^ <br /> V • • S <br /> '' • City of Sunny Isles Beach <br /> • <br /> 9 - L's.q O� 18070 Collins Avenue <br /> SfC'"•F.o?- D,` Sunny Isles Beach,FL 33160 <br /> '''or sus'` Telephone:(305)947-0606 Fax:(305)949-3113 <br /> • <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF \)ALM BEA (rl) <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 /> . ---- ---"--L4---'9"-. <br /> By:• <br /> \ r <br /> Title: V TCC 'Y/Z ES Z.00—,,i7" <br /> • <br /> The foregoing instrument was acknowledged before me this --1 1H day of 410 <br /> APP-Zc. -,7 TO , 20 I i ,__,by D,IJip L3 613E "j/z- [name <br /> of person], as Vick Y P-65/De'-r- [type of authority], for <br /> ALL W 4 3 5 601-E2vot:fEs 7N C . [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: • (.ete4a., , <br /> NICHOLAS IEE Notary Public — State of Florida <br /> • <br /> t„�; Commission# FF 982474 L <br /> ���ss,,1a ,F My Commission Expires iC-f DL-4 s C C <br /> .'�.;o;,''�,��' April 14, 2020 ( <br /> Print or Type Commissioned Name <br /> • <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced . <br /> II <br /> 7 of 10 <br />