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STATE OF FLORIDA <br />COUNTY OF PALM BEACH <br />I, , a Notary Public in and for said County in said State, hereby <br />certify that on , 2016, , whose name as the (Vice) <br />Chairman of the Palm Beach County Health Facilities Authority is signed to the foregoing <br />Fourth Amendment to the Interlocal Agreement and who is known to me, acknowledged before <br />me on this day that, being informed of the contents of said Fourth Amendment to the Interlocal <br />Agreement, he/she, in his/her capacity as (Vice) Chairman of the Palm Beach County Health <br />Facilities Authority, executed the same voluntarily. <br />Notary Public, State of Florida <br />My Commission Expires: <br />-10- <br />