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STATE OF New Jgsey <br />COUNTY OF Passaic ) <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: Associate Princi <br />t� <br />The foregoing instrument was acknowledged before me thisi = day of <br />20 ;U by Adrienne S. Burg [name <br />of person], as Associate Principal [type of authority], for <br />Horton Lees Brogden Loghting Desogn Inc. [name of party o -behalf of whom instrument was <br />executed]. 7; �j' <br />AFFIX NOTARY STAMP HERE: <br />Aw 11a De t aCruz-Gorman <br />NOTARY PUBLIC OF NEW JERSEY <br />Cone .ssion #24460 X024 <br />Mh Commissbn <br />Public — S- <br />nt or Type Commissioned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />264- <br />New Jersey <br />