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Name of Affiliate Name of County Relationship <br /> or Entity Commissioner or employee <br /> 2 . <br /> 3 . <br /> 1 4 <br /> 5 . <br /> 6 . <br /> 1 8 . <br /> 1 <br /> ( signature ) <br /> ( date ) <br /> 1 <br /> STATE OF 'f'! 0 ri pla <br /> COUNTY OF <br /> 1 Personally appeared before me , the undersigned authority , P� � C <br /> w o a er first beina sworn by me , ffixed his/her si nature in the space provided above on this <br /> day of 120 � <br /> " Alysa C. Comfort <br /> MY COMMISSION # CC909615 EXPIRES <br /> May 26, 2004 <br /> 1 'p IF BONDED THRU TROY FAIN INSURANCZ INC <br /> Notary Public , State at large , <br /> My Commission Expires : <br /> 1 * * END OF SECTION <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> Disclosure of Relationships <br /> 00452 - 2 <br /> FAIDuhlic Works\Capital Projects\Oslo • 43rd Avenue\CONTRACT DOCUMENTS\Disclosure of Relationships.doc Rev. 05/01 <br />