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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 />Name of Affiliate <br />or entity <br />STATE OF Florida <br />COUNTY OF Brevard <br />Name of County Commissioner <br />or employee <br />Relationship <br />S -L Erik Costin <br />(Signature) <br />7/13/18 <br />(Date) <br />The foregoing instrument was acknowledged before me this 13 day of July , 2018 by <br />Erik Costin , who is personally known to me or who has produced <br />as identification. <br />NOTA LIC <br />SIGN: <br />PRINT: Shelley ut erland <br />Notary Public, State at large <br />My Commission Expires: <br />(Seal) <br />.w+..>y SHELLEY D. SUTHERLAND <br />?q. MY COMMISSION # FF 224376 <br />EXPIRES: June 8 2019 <br />%FliF wd ` Bonded Thru Notary Public Undenrrtitera <br />00452-2 <br />FAPublic Works\ENGI N EER I NG DIVISION PROJ ECTS\1 744 Sebastian Comers\1-Admin\Bid Documents\MasterContract\Master Contract <br />Documents\00452 Disclosure of Relationships.doc <br />