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2018-038A
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2018-038A
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Last modified
12/21/2020 12:43:43 PM
Creation date
3/15/2018 11:23:59 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
02/20/2018
Control Number
2018-038A
Agenda Item Number
8.S.
Entity Name
Johnson-Davis, Inc.
Subject
Culvert Replacement
Area
74th Avenue and 1st Street SW
Project Number
1737
Bid Number
2018024
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i <br />RFP IRC1737-74th Ave and 1st Street SW <br />entity, have any relationships as defined In section 105.08, Indian River County Code, with any <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 entity or employee <br />N/A <br />ure) fey. <br />(Date <br />STATE OF 1 crftjoi <br />COUNTY OF T)c&kk h <br />The foregoing instrument was acknowledged before me this 7-3Ydday of OLKO "cc 201's , by_ <br />�CO --J�TOhrw <br />h ; who is personally known to me or who has produced <br />as identification. <br />NOTr{ARY PUBLIC <br />SIGN: G—k-q ��\ <br />PRINT: M V\ <br />Notary Public, State at large <br />My Commission Expires: '2115 2OZO, <br />(Seal) <br />� � Puffin YAMU'rH HOFFMAN <br />x <br />MY COMMISSION A GG 021598 <br />Nnw <br />EVRES:Aupud15,2D20 <br />Page 13 of 14�lbndedTlwBudpctNoterySeMac <br />
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