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relationships as defined in section 1.05.08, Indian River County Code, with any County Commissioner <br />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 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 Indian River <br />Name of County Commissioner <br />or employee <br />Relationship <br />(Signature) <br />04.23.2020 <br />(Date) <br />The foregoing instnunent was acknowledged before me this 23rd day of April , 20 20, by <br />Timothy Rose , who is pelrsopal! known to me or who has produced <br />as identification. <br />NOTARY PUBLIC <br />SIGN: <br />PRINT: Deborah West <br />Notary Public, State at large <br />My Commission Expires: <br />(Seal) <br />'�eaoxtWEST <br />0 <br />EXPIRES: Normbe1,202; <br />00452-2 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1325 58th Avenue (57th St to CR 510) Roadway Inventory\1-Admin\Bids\Bid <br />Documents\00452 Disclosure of Relationships.doc <br />