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7 <br /> �.00 N y,s4 <br /> :", _ oT. ANTI - KICKBACK <br /> 7 <br /> • City of S <br /> •, ,- 18070 CollinsunnyIsles AvenueBeach <br /> of D' •F 00.'C h*' Sunny Isles Beach,FL 33160 <br /> c'''or Fut+ " Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF Mimi. OadL ) <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: Cqb( ,\le. ven;cri <br /> Title: c7rts;cLt4lJr <br /> The foregoing instrument was acknowledged before me this c."—day of <br /> /75z y , 20 f' by �, [name <br /> of person],/ as /`,_ _ /, = [type of authority], for <br /> i' [ ame of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> • <br /> No Public — S to of Florida <br /> p"% HASHATH MORALES <br /> \046/ MY cor nEa:M2=1 a 0,2020 •Pesk�tr`It OA 0 R-PA e, <br /> p,)PIItES:MercL 30,2020 <br /> ' Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced ,�s.#-2/ . ,d i 2x, —''s 6 4:::.77y. <br /> 7 of 10 <br />