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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 /> CL <br /> (signature) <br /> 7l/� �Oa <br /> (d e) <br /> STATE OF ! <� <br /> COUNTY OF 1t i Ve <br /> Personally appeared before me , the undersigned authority , 3rrp C t� icf it t << nr> <br /> who after first beiW sworn by me , affixed his/her signature in the space provided above on this <br /> // -"r'' day of 4/ z , 20 QY . <br /> J J NOTARY PUBLIC • STATE OF nORIDA <br /> Notary ublic , State large " • BeVerly Kenny Fejt <br /> My C mmission Expires : eF /c an ,` emission # DD629777 <br /> / BOIZE T EXpires, JAN 1 b 2011 <br /> HRUATLNITC BONDING CO., zic <br /> * * END OF SECTION <br /> 00452 - Disclosure of Relationships <br /> 00452 - 2 <br /> F•\Fnoirw.wino\PPtition Pavina\0522 1st Rd. from 32nd Ave. to 35th Ave\Bid Documents\00452 - Disclosure of Relationshios.doc <br />