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_ efitlty submitting this swoiii stail�-- _ itie oriicers, cureccors, e�ecu[[ves, <br /> Shareholders, ernployeeS. active In management of the mtlt y <br /> - ~e following relationships with a C.-- .­.. _ - ,[• County employee: <br /> :Nate Name of Corti,. C--m 1',1 5z Relationship <br /> or emplov.-e <br /> (Signature) <br /> (Date) <br /> ®r <br /> :r.strument was acknowledged before me this_�day of N0,U 20Lq, by <br /> who is personally known to me or who has produced <br /> as identification. <br /> NOTARY PUBLIC <br /> SIGN: (0,ylf�'Al <br /> PRINT: <br /> otary Public, State at large <br /> My Commission Expires: it, 3 \S <br /> (Seal) DEBOR ".1 <br /> MY COMM[-S N M EM03e- <br /> EXPIRES :txxcba t t :q ; <br /> 00452-2 <br /> s ENGINEERING DIVISION PROJECTS\084513-Old Dixie Hwy Sidewalk(38t�, -= aster Contract <br /> _ :=-52 Disclosure of Relationships.doc <br />