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Name of Affiliate Name of County Commissioner Relationship <br /> or entity or employee , <br /> (Signature) <br /> ( at ) <br /> STATE OF f� 0Ni � � <br /> 1 COUNTY OF17f-v44 441 k <br /> The foregoing instrument was acknowledged before me this day of ��� u[ t1 -4� ►'c _ �= 20L-�,) by <br /> tv�, -D C' , who is personally known to me or who has produced <br /> P%J �,� as identification . <br /> O <br /> LYUBLIC <br /> P C <br /> SIGN : <br /> PRINT : <br /> Notary Public , State at ta ge <br /> My Commission Expires : �j � 111 ) ;2p I �L <br /> (Seal) <br /> I4CPPY PLA VICKIE LEE. WRIGHT , <br /> r° * Notary Public • 6tatO of Florida I <br /> March 11 , 2012 <br /> t * � My Commlaalon exp . I <br /> moo ,*adv Cammir�lan # Cn 799 <br /> 00452-2 <br /> F :\Public Works\ENGINEERING DIVISION PROJECTS\ 1136-6th Ave SW_Culvert Replacement N of 23rd St SW\Admim\Contract Documents\00452 <br />