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(12-06-01) Construction Management for Gateway Park
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Target Engineering Group
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Last modified
6/14/2012 11:46:34 AM
Creation date
6/14/2012 11:36:38 AM
Metadata
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Construction Management Svcs for Gateway Park
Bid No. (xx-xx-xx)
12-06-01
Project Type (Bid, RFP, RFQ)
RFQ
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O� SUNNY �S(`c�d <br />a � <br />U - _ <br />rl <br />P t <br />6. 6 F 54 <br />C /Tr Di SuN 0 <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -Dade ) <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 />i 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 />6:1 <br />By: <br />LJ <br />Title: Executive Vice President <br />[1 <br />I t� <br />t�— <br />The foregoing instrument was acknowledged before me this day of <br />t he__ , 20/ Z_ , by Ramzi Asfour, P.E. [name <br />of person], as Executive Vice President [type of authority], for <br />Target Engineering Group, Inc. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />MARC POMERANTZ <br />` MY COMMISSION # DD993972 <br />',?;r,�d�' EXPIRES May 20, 2014 <br />(407) 398.0153 FlondallotaryService.com <br />4YL6- Lp <br />� <br />Notary Public— State of Florida <br />POM MCA CC f000tZ <br />Print or Type Commissioned Name <br />Personally Known OR Produced I entification <br />Type of Identification Produced KO <br />DECEMBER 28, 2010 <br />7 of 7 <br />
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