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Name of Affiliate Name of County Relationship <br /> or Entity Commissioner or employee <br /> 1 . <br /> 2 . <br /> 3 . <br /> 4. <br /> 5 . <br /> 6 . <br /> 7. <br /> 8 . <br /> (signature) <br /> N0V ► IQQK <br /> (date) <br /> STATE OF ` <br /> COUNTY OF <br /> Personally appeared before me , the undersigned authority, '�R i C11 " s )e�l it� <br /> who after first being sworn by me , affixed his/her signature in the space provided above on this <br /> day of NQ1 Y1 (3 P� , 20DB <br /> 0 <br /> e.. <br /> 011oryy <br /> Notary ublic, State at large <br /> My Commission Expires : <br /> * * END OF SECTION <br /> 00452 - Disclosure of Relationships REV 04-07 .doc <br /> 00452 - 2 <br /> FAEngineering\Spedal ProjectMEndave Subdivlalon\Contract Documents\Contract Documents\The Endave.doc\00452 - Disdosure of Reladonships REV 04.07.doc <br />