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STATE OF FLORIDA )
COUNTY OF Miami -Dade )
ANTI -KICKBACK
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
ANTI -KICKBACK AFFIDAVIT
I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid
will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a
commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or
by an officer of the corporation.
Richard Gomez
Title: Vice President
The foregoing instrument acknowledged before me this Zlnd day of
rA Q4 20by 1 ArrA C-nmP [name
of personl, as , ��A [type of authority], for
~TI_SV �'i -� r vse_"' - (name of party on behalf of whom instrument was
executed].
AFFIX NOTARY STAMP HERE: 1
oayP� ISAt3ELCAMEJO SMITH N tary Public —of Florida
?' MY COMMISSION # GG 186668
EXPIRES: June 14, 2022
Bonded Thru Notary Public Underwiiters Isabel Came j o -7Mk:it h
Print or Type Commissioned Name
Personally Known OR Produced Identification
Type of Identification Produced
DECEMBER28,2010 7 Of 8