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rIOP\ `¢ <br />city or sud <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 />By: <br />Title: President <br />The foregoing instrument was <br />U��>�,✓,- 20 by <br />of person], as Ri re.!�r� <br />% Su O SCu0� '� Vppc <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />JOSE M. QUINTERO <br />MY COMMISSION # HH 013695 <br />EXPIRES: August 11, 2024 <br />Bonded Ttuu Notary Public Underwriters <br />Personally Known <br />Type of Identification <br />acknowledged before me this <br />[type <br />of <br />[name of party on behalf of <br />whom <br />�_ day of <br />[name <br />authority], for <br />instrument was <br />ry Public —State of Florida <br />Print or Type Commissioned Name <br />✓ OR Produced Identification <br />Produced ,� / (A <br />DECEMBER 28, 2010 � Of a <br />