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SUNY,„J <br /> a!?. <br /> „..-..,.„...-<.0, <br /> �( i= <br /> ANTI - KICKBACK <br /> c� • <br /> - City of Sunny Isles Beach <br /> ->.--1- ��� 18070 Collins Avenue <br /> '. �''•o oo+ Sunny Isles Beach,FL 33160 <br /> Of ,us• Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF PALM BEACH ) <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 /> • <br /> By: t. .„, ./ ' it <br /> Title: Martha A. Morgan, President) / <br /> The foregoing instrument was acknowledged before me this 9th day of <br /> September 20 15 , by Martha A. Morgan I [name <br /> of person], as President [type Of authority], for <br /> West Construction, Inc. [name • 'arty on behalf of whom instrument was <br /> executed]. ! <br /> AFFIX NOTARY STAMP HERE: Llr/tilt. <br /> � <br /> � �., Rncauaae rT N'tary 'ublic- da itt <br /> IC , MY00/MISSIONrFf236934 I <br /> m4 EXPIRES:k9e3,2019 '.acqu-' J. Barret <br /> %cc,.- Bad•11Lry BufaGettilYSmta <br /> P int or Type Commissioned Name <br /> Personally Known ✓ OR Produced Identification <br /> Type of Identification Produced <br /> oECEUarR 213.2010 7 of 10 <br />