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The entity submitting this sworn statement, or one or more of the officers, directors, executives, <br />partners, shareholders, employees, members, or agents, who are active in management of the entity <br />have the following relationships with a County Commissioner or County employee: <br />Name of Affiliate Name of County Commissioner Relationship <br />or entity or employee <br />None <br />(Signature <br />Martha A. Morgan, President <br />12/02/2015 <br />(Date) <br />STATE OF FLORIDA <br />COUNTY OF PALM BEACH <br />The foregoing instrument was acknowledged before me this 2nd day of December <br />Martha A. Morgan <br />,2015, by <br />who is personally known to me or who has produced <br />as identification. <br />00452-2 <br />otary Public, State at large <br />My Commission Expires: June 3, 2019 <br />(Seal) ex ;0a, RACQUEL J. BARRETT <br />* MY COMMISSION # FF 236934 <br />* <br />nin.- • EXPIRES: June 3, 2019 <br />��rEdF wfro Bonded Thru Budget Notary Services <br />F:1Public Works\ENGINEERING DIVISION PROJECTS \1213B -IRC Shooting Range Skeet 2. Trap Phase 21Admin\bid documents\Master Contract Documents100452 Disclosure of Relationships.doc <br />