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2021-207A
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2021-207A
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Last modified
1/26/2022 11:15:25 AM
Creation date
1/26/2022 10:53:42 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
12/14/2021
Control Number
2021-207A
Agenda Item Number
8.I.
Entity Name
Ferreira Construction Southern Division Co., Inc.
Subject
Award of Bid for 66 th Avenue and 8 th Street
Signalization Project Improvements
Project Number
IRC-2002
Bid Number
2022007
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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 <br />have the following relationships with a County Commissioner or County employee: <br />Name of Affiliate <br />or entity <br />Not Applicable <br />STATE OF FLORIDA <br />COUNTY OF MARTIN <br />Name of County Commissioner <br />or employee <br />Relationship <br />Robert H gginbotham, V P(i nature) <br />November -17, 2021 <br />(Date) <br />Sworn to (or affirmed) and subscribed before me by means of ® physical presence or ❑ online <br />notarization, this 17th day of November 20 21 , by Robert Higginbotham, V P (name <br />of person making statement). <br />1g R Cecilia Rase Hein <br />o� o� NOTARY PUBLIC <br />a STATE OF FLORIDA (Signature of Notary Public - State of Florida) <br />Comm# GG343610 <br />Expires 6/2912023 (Print, Type, or Stamp Commissioned Name of Notary Public) <br />S�kCE 19�a <br />0 who is personally known to me or O who has produced <br />as identification. <br />Sworn Statement of Disclosure of Relationships - 00452-2 <br />FlPublic Works1ENGINEERING DIVISION PROJECTS12002 66th Ave and 8th St SignalizatioMl-AdminlBidskDd DocumentslDIV 0 2_Biddng Documents - 20201002.docx <br />
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