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1,70ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> ,'D:t 4T:� 18070 Collins Avenue <br /> +,£ �.F�oaW +4. Sunny Isles Beach,FL 33160 <br /> r'''0,sui,'}° Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> Q ) <br /> COUNTY OF `mc-cu�cC-t) <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 /> By: 'h'/��� <br /> G�� <br /> Title: � ' 5 i Caen-k <br /> The foregoing instrument was - acknoedged before me this 1$ day of <br /> t 1 20 'I. , iby in ' . ' 0 C [name <br /> {3lil <br /> of person], as , ' 0 ��cAlyi L f7.t?. 5Ut .) [type of authority], for <br /> LOPS 1.-C ioInC • [name off party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> ())4'sj,\PCn C41 MO <br /> Nota lic— St of Florida <br /> q /Pr <br /> •� I P��.,,„ AMY JEAN HOFFMAN ///111 <br /> ;•r° --1�`s;': Notary Public-State of Florida 0 / Lm Jean <br /> � <br /> Commission#r FF 980214 !-1t 1 <br /> i•,.. • �c <br /> �,��`�?,• My Comm.Expires Apr 19, �320 � Print or ype Commissioned Name <br /> 1 �,�������� Bonded through National Notary Assn. <br /> Personally Known 1( OR Produced Identification <br /> Type of Identification Produced <br /> 7 of 10 <br /> Lukes' Landscaping, Inc. <br />