Laserfiche WebLink
:s%) N <br /> ANTI - KICKBACK <br /> x City of Sunny Isles Beach <br /> ? 18070 Collins Avenue <br /> 'c. ,` SunnyIsles Beach,FL 33160 <br /> C' _. {ORNo <br /> 1';' uN' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF M W&2 ) <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 /> I <br /> I <br /> By: <br /> Title: C Po <br /> The foregoing instrument as cknowle/dgJLe <br /> ed fore me this 14� day of <br /> 40 , 20 , by �410 'iJv [name <br /> o.fi person], / as _ Cto [type of authority], for <br /> Y',C -J vu'ee ..4 .t Z . [name of party on behalf of whom instrument was <br /> executed]. 1 <br /> AFFIX NOTARY STAMP HERE: <br /> Notary Publ c — State of Florida <br /> mer we Notary Public State of Florida I <br /> igir Ratteray �•, M ( ct* ;�i <br /> � My Commission FF 978529 lit <br /> ?o, / p;res04f0412o2o - <br /> Print or ype Commissioned Name <br /> Personally Known y OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 <br />