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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 have <br />the following relationships with a County Commissioner or County employee: <br />Name of Affiliate <br />or entity <br />STATE OF FL <br />COUNTY OF Hillsborough <br />Name of County Commissioner <br />or employee <br />Relationship <br />J� <br />(Signature) <br />09/02/20 <br />(Bate) <br />Sworn to (or affirmed) and subscribed before me by means of El physical presence or ❑ online notarization, <br />this 2 day of 20 20 by Les Mouzon name of g ) <br />sept. ( person making statement). <br />(Signature of Notary Public - State of Florida) <br />(Print, Type, or Stamp Commissioned Name of Notary Public) <br />2pt�!F P LAUREN RHODE <br />.; MY COMMISSION 4 GG 974576 <br />po: EXPIRES: March 31, 2024 <br />%:;OF FL�.•, Bonded ihru Notary Public Underwriters <br />Swom Statement of Disclosure of Relationships - 00452-2 <br />FAPublic Works\ENGINEERING DIVISION PROJECTS\1801A IRC Courthouse Parking Garage Rehabi1itation\1-Admin\Bids1Bid Documents0d Dcuments\DIV 0_2_Bidding Documents.docx <br />