Laserfiche WebLink
• sV)t:4 Y'Itf <br /> . l <br /> • ,o ANTI - KICKBACK <br /> u(-^ 1 ; I91- <br /> ® City of Sunny Isles Beach <br /> ® 4 )9'\O�" t 18070 Collins Avenue <br /> SI CD9 •FLOSE Sunny Isles Beach,FL 33160 <br /> sot+' Telephone:(305)947-0606 Fax (305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> S <br /> ® STATE OF FLORIDA ) <br /> ® COUNTY OF A D£ ) <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 /> 11 <br /> • By: TI moil , \ZO� <br /> Title: P <br /> • The foregoing instrument was acknowledged before me this 64-1- day of <br /> ® p€ lea_ , 20 11 , by i rrc * 3 t\ 2e 1 [name <br /> ® of person], as V. c- -Pr-e-.5% "k [type of authority], for <br /> • (orrit [name of party on behalf of whom instrument was <br /> executed]. <br /> 410 AFFIX NOTARY STAMP HERE: <br /> Ara <br /> /�• f r�r+ic Staterof Florida <br /> ® <br /> �*'*::�",, YOLENE lAENDOlA <br /> a+r iei .r. <br /> MY COMMISSION#FF 191639 <br /> • <br /> EXPIRES:February26,2019 i I' f Q� O f� <br /> "of„� '` Banded Ttw Wlary Public uadennilers <br /> ® Prin or Type Commissioned Name <br /> • <br /> ® Personally Known D OR Produced Identification <br /> Type of Identification Produced <br /> • <br /> • <br /> ® 7 of 7 <br />