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SWORN STATEMENT UNDER SECTION 105. 08, INDIAN RIVER COUNTY CODE, ON
<br /> ' DISCLOSURE OF RELATIONSHIPS
<br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br /> ' OFFICER AUTHORIZED TO ADMINISTER OATHS .
<br /> 1 . This sworn statement is submitted with Bid, Proposal or Contract No . 6079 for
<br /> Security Fencing for South County RO Plant
<br /> 2 . This sworn statement is submitted by: NATIONS FENCE , INC .
<br /> (Name of entity submitting Statement)
<br /> whose business address is :
<br /> 4640 NORTH USI MELBOURNE, FLORIDA 32935 and (if
<br /> applicable) its Federal Employer Identification Number (FEIN) is 52-2201 - 638 (If the entity has
<br /> ' no FEIN, include the Social Security Number of the individual signing this sworn statement
<br /> . )
<br /> 3 . My name is MAURICE PEZONE
<br /> (Please print name of individual signing)
<br /> and my relationship to the entity named above is INDUSTRIAL SALES
<br /> 4 . I understand that an "affiliate" as defined in Section 105 . 08 , Indian River County Code,
<br /> ' means : The term "affiliate" includes those officers, directors , executives, partners ,
<br /> shareholders , employees , members , and agents who are active in the management of the
<br /> ' entity.
<br /> 5 . I understand that the relationship with a County Commissioner or County employee that must
<br /> ' be disclosed as follows :
<br /> Father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece,
<br /> ' husband, wife, father-in- law, mother-in-law, daughter-in- law, son-in- law, brother-in- law ,
<br /> sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half
<br /> brother, half sister, grandparent, or grandchild .
<br /> ' 6 . Based on information and belief, the statement, which I have marked below, is true in relation
<br /> to the entity submitting this sworn statement . [Please indicate which statement applies . ]
<br /> ' X Neither the entity submitting this sworn statement, nor any officers , directors ,
<br /> executives, partners , shareholders , employees, members , or agents who are active in
<br /> ' management of the entity, have any relationships as defined in section 105 . 08 , Indian River
<br /> County Code, with any County Commissioner or County employee .
<br /> The entity submitting this sworn statement, or one or more of the officers, directors ,
<br /> executives, partners , shareholders , employees , members , or agents , who are active in
<br /> management of the entity have the following relationships with a County Commissioner or
<br /> County employee :
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