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' Name of Affiliate Name of County Commissioner Relationship <br /> or entity or employee <br /> (Signature) <br /> ' 6-9-2004 <br /> (Date) <br /> ' STATE OF FLORIDA <br /> COUNTY OF INDIAN RIVER <br /> ' The foregoing instrument was acknowledged before me this 9th day of JUNE , 2004 , by <br /> MAURICE PEZONE who is personally known to me or who has <br /> ' produced FLORIDA DRIVERS LIC P250- 541 -44- 143 -U as identification . <br /> NOTARY PUBLIC <br /> SIGN : <br /> PRINT : KENNETH B . AUSTIN, JR. <br /> State of Florida at Large <br /> ' My Commission Expires : 6- 16- 06 <br /> (Seal) <br /> ' Page 37 of 52 <br />