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SUNNY IS," <br />F f <br />9 <br />S•� ➢� 4p0 QYs� <br />y Oi SUM <br />STATE OF FLORIDA ) <br />COUNTY OF DADE ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />ANTI - KICKBACK AFFIDAVIT <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 />Frank D. Crawley <br />Title: President <br />The foregoing instrument w k kno� [edged] -before me this day of <br />2 by 7nZ [ name <br />p rson], as [ of authority], for <br />j0pje>�t parry on h of hom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Notf Public — State of Florida <br />/2 4 Ag!z" - 1152 !a. , <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />ROSA C. AItCEA <br />Pue`-k i Notary Public - State of Florida <br />. My Comm. Expires Dec 26, 2016 <br />foF Commission f EE 832167 <br />' Bonded Through National Notary Assn. <br />DECEMBER 28, 2010 7 of 7 <br />