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2020-116D
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2020-116D
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Last modified
3/2/2021 2:17:19 PM
Creation date
3/2/2021 2:15:07 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
06/23/2020
Control Number
2020-116D
Agenda Item Number
8.N.
Entity Name
Atlantic Roofing II of Vero Beach, Inc.
Subject
Contract Documents for Indian River County Main Library Roof Replacement
(IRC-1338) Bid No. 2020029 for Project No. IRC-1838
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Bid No. 2020029/IRC-1838 <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, <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 Name of County Commissioner Relationship <br />or entity or employee <br />(SignVre) <br />6-3-20 <br />I <br />(Date) <br />STATE OF Florida <br />COUNTY OF Indian River <br />The foregoing instrument was acknowledged before me this 3rd day of June 20 20 , by_ <br />William Lasky Jr who is personally known to me or who has produced <br />as identification. <br />NOTARY PUBLIC <br />i <br />SIGN: <br />PRINT: ( I- t <br />Notary Public, State at large <br />My Commission Expires: <br />(Seal) <br />Page 19 of 39 ;off aYP^ " DEBORAH L. AUST:2:5,7] <br />Commission # GG Expires January 6, Banded Thru Troy Fain I <br />i <br />I <br />I <br />
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