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Of SV ,NY /e <br />n <br />vi I. <br />R <br />(`,rr `il0 RR St' <br />or su*•' <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -Dade ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />16070 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 oor any member of my firm or <br />by an officer of the corporation. j'` /r <br />The foregoing instrument <br />C 20 / f by <br />of pers n], as <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Es <br />Title: President <br />was. acknowledged before me this !o �'— day of <br />*amp V, C'_c-, 4_S ,, [name <br />[name of party on <br />[type of authority], for <br />behalf of whom instrument was <br />Notary Pubik — State of Florida <br />Esperanza Chirino <br />Print or Type Commissioned Name. <br />Personally Known ✓ OR Produced Identification <br />Type of Identification Produced <br />DECEMBER28.2010 7 of 10 <br />Notary public - Stale of Florida <br />My Comm. Expires Feb 24, 2011 <br />Commission N FF 095275 <br />