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SECTION 20 <br />ANTI - KICKBACK AFFIDAVIT <br />STATE OF FLORIDA ) <br />COUNTY OF ) <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum <br />herein proposal will be paid to any employees of the City of Sunny Isles Beach or its <br />elected officials as a commission, kickback, reward or gift, directly or indirectly by me or <br />any member of my firm or by an officer of the corporation. <br />Title: <br />The foregoing instrument was acknowledged before me this <br />20 , by <br />[name of person], as <br />was executed]. <br />AFFIX NOTARY STAMP HERE: <br />day of <br />[type of authority], for <br />[name of party on behalf of whom instrument <br />Notary Public — State of Florida <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />END OF SECTION <br />PAGE 104 OF 105 <br />PROPOSAL NO. <br />