Laserfiche WebLink
STATE OF FLORIDA ) <br />COUNTY OF j3r4wa (Z ) <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: &0, 1 < <br />Title: �Lr� <br />The foregoing instrument was acknowledged before me this JF day of <br />Mara(-• 20 1 Ci by g A PJL 1 [name <br />of person], as Sues mcm!Me(- [type of authority], for <br />G 3 1- (L1 -c- [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />.s::'ri/a•. DANE RAMIREZ <br />''"• •��" MY COMMISSION # GG 195616 <br />,- EXPIRES: March 13,2022 <br />Bonded Thru Notary Public Underwriters <br />No Public tate of FI <br />IDanc-_ f ZCLMI rel <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification ✓ <br />Type of Identification Produced Floc;ati Dr;JEcS 1,; certrc <br />DECEMBER2B,2010 7 of <br />