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XI . Sworn Statement : To be returned with proposal .
<br /> SWORN STATEMENT UNDER SECTION 105 . 089 INDIAN
<br /> RIVER COUNTY CODE , ON 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 MUST be submitted with Bid , Proposal . RFP # 2010047
<br /> for INDEPENDENT AUDITING SERVICES
<br /> 2 . This sworn statement is submitted by :
<br /> (Name of entity submitting Statement)
<br /> whose business address is :
<br /> 3 . My name is
<br /> (Please print name of individual signing)
<br /> and my relationship to the entity named above is
<br /> 4 . 1 understand that an "affiliate" as defined in Section 105 . 08 , Indian River County Code , means :
<br /> The term " affiliate" includes those officers, directors, executives , partners , shareholders ,
<br /> employees , members , and agents who are active in the management of the entity .
<br /> 5 . I understand that the relationship with a County Commissioner or County employee that must be
<br /> disclosed as follows : Father, mother, son , daughter, brother, sister, uncle, aunt, first cousin ,
<br /> nephew , niece , husband , wife, father- in - law, mother- in- law, daughter- in - law, son- in - law, brother-
<br /> in - law, 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 to
<br /> the entity submitting this sworn statement . [Please indicate which statement applies . ]
<br /> Neither the entity submitting this sworn statement, nor any officers , directors , executives,
<br /> partners , shareholders , employees , members , or agents who are active in management of the
<br /> entity , have any relationships as defined in section 105 . 08 , Indian River County Code , with any
<br /> County Commissioner or County employee .
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