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ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> %.iD9'•LORSO' � <br /> ." Sunny Isles Beach,FL 33160 <br /> c r`o. sus' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Miami-Dade ) <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: _ Al `�-- <br /> _/AL <br /> Title: Leyvis T. Quintana - President <br /> The foregoing instrument was acknowledged before me this 7th day of <br /> December , 20 18 , by Levvis T. Quintana [name <br /> of person], as President [type of authority], for <br /> Azulejo, Inc. [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: g614--€7 , <br /> P� `o� 2p2r- Notary P blic— State of Florida <br /> $1U4 ,,to._ Feo��arl���0‘.. <br /> ,►, '0,s EA) Aco�N� Alexandra Rodriguez <br /> *'•f ;14F" s?03 Print or Type Commissioned Name <br /> Personally Known xx OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 <br />