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o <br />B <br />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 />BName of Affiliate <br />1 <br />Name of County Commissioner Relationship <br />or entity or employee <br />Q <br />STATE OF Florida <br />COUNTY OF s t . <br />ri <br />0 <br />o <br />Lucie <br />The foregoing instrument was acknowledged before me this <br />Larry T. Dale , who is personally known to me or who has produced <br />as identification. <br />August 27, 2014 <br />(Date) <br />27th day of August <br />, 20 14• by <br />SIGN: <br />PRINT: 09w -wive -ire- "6 %c e5od <br />Notary Public, State at large <br />My Commission Et <br />ETTE PETERSON <br />NOTARY PUBLIC <br />Seal ' r STATE OF FLORIDA <br />Comm# EE026292 <br />Expires 9/29/2014 <br />4'E 91 <br />00452-2 <br />F:Public Woske1ENGINEERING DMSION PROJECTSW530B 13th Street SW at 58th Ave Bridge1Adminlbid documents Master Contract <br />Docurnenta100452 Disclosure of Relntlonshkss.dac <br />