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04,s:3-!!':—*LA,, <br /> f <br /> .� ANTI — KICKBACK <br /> uj' `_ �� City of Sunny Isles Beach <br /> \C 18070 Coffins Avenue <br /> c i�'„o Sunny Isles Beach,FL 33160 <br /> 'o. 1us ■ Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF b4± ) <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: Z°fil Pt SA4NC jit z <br /> Title: U!/LeC l 6/Z of- S4)es <br /> The foregoing instrument was acknowledged before me this DCn day of <br /> i4ucr() V4 , 20 f5 , by Cite) inuott S4Nci4i= z— ! [name <br /> of person], as Ei2e c ocL Of S4/-eS [type of authority], for <br /> 1< C LeA ^i Cottp [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> /JP—) ' <br /> p�� Notary Publi — State of Florida <br /> qty, ligia Paz <br /> , 4 State of Florida L (9 I Ct -2— <br /> rzi' My Expires 1210412018 Print or Type Commissioned Name <br /> ^,;•O+ Commission No.FF 181393 yp <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced Flo-Lida On rev 1.1 a.tus( <br /> DECevaER 29,2010 T o1 10 <br />