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�✓ SWORN STATEMENT UNDER SECTION 105 . 089 <br /> INDIAN 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 or Contract No . 2010029 <br /> for Bid for Operations of the Biosolids Dewatering Facility Sludge Dewatering and Hauling <br /> 2 . This sworn statement is submitted by : Synagro South , LLC <br /> (Name of entity submitting Statement) <br /> whose business address is : <br /> 1002 Village Square , Suite C , Tomball , TX 77375 <br /> and its Federal Employer Identification Number (FEIN) is 76 -0612568 <br /> 3 . My name is Karl J . Scott <br /> (Please print name of individual signing) <br /> and my relationship to the entity named above is Vice President & Assistant Secretary <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 . 1 understand that the relationship with a County Commissioner or County employee that must <br /> be disclosed as follows : <br /> Father , mother, son , daughter, brother, sister, uncle , aunt , first cousin, nephew , niece , husband , <br /> wife , father-in- law mother- in-law daughter-in- law son- in-law, brother- in-law , sister-in-law, <br /> stepfather, stepmother, stepson, stepdaughter , stepbrother, stepsister, half brother, half sister , <br /> grandparent , or grandchild . <br /> Page 27 of 47 <br />