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O� '"My +St f f l <br />ot <br />01 su" <br />a �^ <br />u�. z <br />STATE OF FLORIDA ) <br />COUNTY OF i/ ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 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 or any member of my firm or <br />by an officer of the corporation. <br />The foregoing instrument <br />20 l , by <br />of per on], as <br />E r--,v i rte W lo,_:-5te � I ees 4 <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />�K JELEANY VALDMA <br />*: MY COMMISSION # EED41823 <br />EXPIRES November 15, 2014 <br />too 3g8 -0153 <br />FlorklMoterySevyloo.corn <br />Personally Known �k <br />Type of Identification Produced <br />By: -- —� <br />Title: y,P C.© a <br />was acknowledged before me this day of <br />F [name <br />[type of authority], for <br />(Wname of party on behalf of whom instrument was <br />tary Pub — State of Florida <br />JN , a <br />dylyu(I <br />I� <br />Print or Typ ommissioned Name <br />OR Produced Identification <br />DECEMBER 28, 2010 7 of 7 <br />