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RFP No. 18-04-02 Disaster Debris Management and Removal Services
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KDF Enterprises
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Last modified
5/11/2018 3:03:13 PM
Creation date
5/11/2018 12:25:27 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Disaster Debris Management
Bid No. (xx-xx-xx)
18-04-02
Project Type (Bid, RFP, RFQ)
RFP
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SUNNY,s <br /> ANTI - KICKBACK <br /> u z <br /> ` City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> sFc �.Fcoa` os'' Sunny Isles Beach,FL 33160 <br /> 'r or sus '''' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF Miami-Dade ) <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: - AZ <br /> Title: CFO <br /> 110 fl 71 The foregoing instru ent w to no edged before me this ! day of <br /> ! I c , , 20 / Y, by f a7"r. /Y1a,f--1S.-- [name <br /> of peton], as [type of authority], for <br /> ,'��� .v�h f p�;ie, / �'<<" [name of party on behalf of whom instrument was <br /> executed].AFFIX NOTARY STAMP HERE: fi/ <br /> /i_. AL.b.\ <br /> Nota blic ai; <br /> e of-Florida cte-a.. <br /> 0 KIYA MARIE GRIFFIN 1 � <br /> 1 Seal //- <br /> Notary Public-State of Indiana ' AA <br /> Vanderburgh County i_ W GE <br /> I My Commission Expires Apr 9,2025 ' Pri or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced /k! aL <br /> 0 <br /> 7 of 10 <br />
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