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2015015 - Head Island <br />-entity; anyretationshi°ps-as -defined -in-seetion Yti5.ii6; Indian -River -C-crunty--Code, withra y - <br />County Commissioner or County employee. <br />The entity submitting this sworn statement, or one or more of the officers, directors, <br />executives, partners, shareholders, employees, members, or agents, who are active in <br />management of the entity have the following relationships with a County Commissioner or <br />County employee: <br />Name of Affiliate Name of County Commissioner Relationship <br />or eptity or employee <br />STATE OF r/111-4 <br />9 <br />COUNTY OF <br />QSGG�1 <br />The foregoing instrument was acknowledged bef <br />, who is <br />-ignature) <br />/4//19/q - <br />(Date) <br />h' 9 day of n10 //1441721.64t,420 by <br />erspally know <br />as iden i 'cation. <br />SIGN: <br />I �►pV P /q•• <br />6;I14 <br />AMY M HAR7MAN <br />tFF Notary Public - State of Florida <br />My Comm. Expires Jun 10, 2016 <br />%' Commission 1 FF 128672 <br />Page 14 of 25 <br />to me or who has produced <br />NOTARY PUBLIC <br />VU h1- Mei <br />Notary Public, State at Targe <br />My Commission Expires: <br />(Seal) <br />186 <br />