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corporation, trust, or any form of representative capacity whatsoever for others, Seller shall provide a <br /> fully completed, executed, and sworn beneficial interest disclosure statement in the form attached to <br /> this Agreement as an exhibit that complies with all of the provisions of Florida Statutes Section <br /> 286 .23 prior to approval of this Agreement by the County. However, pursuant to Florida Statutes <br /> Section 286 .23 (3)(a), the beneficial interest in any entity registered with the Federal Securities and <br /> Exchange Commission, or registered pursuant to Chapter 517, Florida Statutes , whose interest is for <br /> sale to the general public , is exempt from disclosure; and where the Seller is a non-public entity, that <br /> Seller is not required to disclose persons or entities holding less than five (5%) percent of the <br /> beneficial interest in Seller. <br /> IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date first <br /> set forth above . <br /> SELLER: INDIAN RdV.ERC0 ICY,Y. FLORIDA <br /> BOARD . IFCOUNT C 1VIISSIONERS <br /> Name : G ne R. Gagliardi. <br /> 13 <br /> By: , Artbdr R NdW ef '72ha' <br /> Date Signed:`f gr 2006 <br /> Date Signed: '1. Dom' <br /> ATTEST : J.K. Barton, Clerk <br /> Name : Rosemary B . Gagliardi By. N � Q <br /> By: nl� �V, ��� . Deputy Clerk <br /> s✓. � .e <br /> Date Signed: 10 - O <br /> Date Signed : C;Z�7 �W4 <br /> Ronald L. Callahan <br /> Real Ee Acquisition Agent Q <br /> By: C"i d' . a„ <br /> Date Signed: 9 2 (v d <br /> APPROVED AS TO FORM// <br /> AND L L SUFFIC Y� <br /> "WILLIAM K . D BRAAL <br /> ASSISTANT COUNTY ATTORNEY <br /> 4 <br /> F:\Engineering\Robert Webb\so66thaveproject\GagliardiAgreement2.doe <br />