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Bid No. 2019074/IRC-1826 <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 <br />or entity <br />STATE OF Florida <br />COUNTY OF Brevard <br />'Name of County Commissioner <br />or employee <br />Relationship <br />10/16/2019 <br />(Date) <br />The foregoing instrument was acknowledged before me this 16 day of October , 2019 by <br />Thomas Camp , who is personally known to me or who has produced <br />as identification. <br />NOT <br />SIGN: <br />PRINT: Shawna Tarrant <br />Notary Public, State at large <br />My Commission Expires: <br />(Seal) ,� <br />LQ Notary Public SfAte of FloridaShawna R. tarrant My ¢ommi, n GG 235283w �xPires 07/04/2022 <br />Page 19 of 42 <br />