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„.SVNtJ.Y'IS ,. <br /> •v.. <br /> ANTI — KICKBACK a <br /> • <br /> .. t = <br /> _ City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> sp 9`'`,Flos''c +` Sunny Isles Beach,FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF F6(61)W#08 ) <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 /> • <br /> By: <br /> Title: C Po <br /> The foregoing instrument as cknowled ed .before me this � `-�1 day of <br /> 20 l4 , by ( A/410 4iity [name <br /> o person], / as C f-D [type of authority], for <br /> VGv-J 14,,fee Y-uZ • [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: i I <br /> �. !. <br /> Notary Pu c — State of Florida <br /> 1r opo Notary Public State of Florida <br /> +F �; KaneYU M <br /> � My CommassionaFF 978529 ” <br /> «J <br /> Expires 20 Print or type Commissioned Name <br /> Personally Known y OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 <br />