Laserfiche WebLink
RFP 2019036 2017-18 CDBG Administration Services <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, executives, <br />partners, shareholders, employees, members, or agents, who are active in management of the <br />entity have the following relationships with a County Commissioner or County employee: <br />Name of Affiliate Name of County Commissioner Relationship <br />or entity or employee <br />STATE OF �1YV (do <br />COUNTY OF P0600 <br />y� <br />The foregoing instrument was acknowledged before me this a3 day of <br />CY\kA(1.,idoi <br />NIA <br />01/23/2019 <br />, who is <br />ersonally known <br />as identification. <br />SIGN: <br />PRINT <br />(Date) <br />20 19 , by _ <br />to me or who has produced <br />NOTAR PUBLIC <br />Page 18 of 20 <br />Notary Public, State at Targe <br />My Commission Expires: <br />(Seal) <br />