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t�VNNY,SFl <br /> �Tt ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> •' \ 18070 Colin Avenue <br /> �r '"•r Eo*'o'+` Sunny Isles Beach.FL 33160 <br /> c'',or so,.►+, Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF ��a� <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: tin MIXq4- <br /> The foregoing instru ent was knowledg before me this �,b day of <br /> C�wkbo-e Y'" , 20 by oSe__ V [name <br /> of person], as Y e cc; A t" [type of authority], for <br /> [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: •_ <br /> Nota '`�'tM.to of Florida <br /> ��r <br /> :.••r <br /> `.''4, EUNA REYES <br /> • MY COMMISSION I FF 054581 <br /> Print or Type Corn .. <br /> -. . . + =1;'t�,2017 <br /> for n- <br /> Personally Nr.vy fenba <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> DEcE1ABER 28.2010 7 of 10 <br />