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Name of Affiliate Name of County Commissioner Relationship <br />or entity <br />NA <br />or employee <br />STATE OF Florida <br />COUNTY OF Orange <br />October 14, 2015 <br />Folwer <br />(Date) <br />The foregoing instrument was acknowledged before me this 14 day of October , 20 15 , by <br />F. Scott Fowler , who is personally known to me or who has produced <br />Personally Known as identification. <br />SIGN: <br />pRINLP,aul K. Carl <br />Notary Public, State at large <br />My Coin Expires: 12-17-2017 <br />`���K CAR So ",,, <br />( kt).•; e104e,.. <br />•O b 2 9°• <br />:-�� ��+N�*Z <br />•moo <br />►•� �oay <br />*0 <br />it? 046562 ¢.• <br />O <br />Banda��cL; ��� <br />/s197,18!.hill t ��\'- <br />00452-2 <br />F•\Public Works\ENGINEERING DIVISION PROJECTS \1304 -CR 512 Resurf (SCOP)_125th Ave to I-951Admim\bid documents\Master Contract <br />Documents\00452 Disclosure of Relationships.doc <br />