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O�SVHNY IS`��B <br />SP DD)r. OT. <br />or SV14 o <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -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 />Richard Gomez <br />Title: Vice President <br />The foregoing instrument acknowledged before me this Zlnd day of <br />rA Q4 20by 1 ArrA C-nmP [name <br />of personl, as , ��A [type of authority], for <br />~TI_SV �'i -� r vse_"' - (name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: 1 <br />oayP� ISAt3ELCAMEJO SMITH N tary Public —of Florida <br />?' MY COMMISSION # GG 186668 <br />EXPIRES: June 14, 2022 <br />Bonded Thru Notary Public Underwiiters Isabel Came j o -7Mk:it h <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER28,2010 7 Of 8 <br />