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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 Name of County Commissioner Relationship <br />or entity or employee <br />tture) <br />Agutar/Vice President <br />11/10/2021 <br />(Date) <br />STATE OF Florida <br />COUNTY OF Indian River <br />Sworn to (or affirmed) and subscribed before me by means of 9 physical presence or ❑ online notarization, <br />this '1 Oth day of November 12021 by Manuel Aguiar / Vice President <br />(name of person making statement). <br />I <br />otirpr cUe •.. =FERNANDEZNDEZ , <br />Notare of Florida Si nature of Nota Public — Sta of Florida <br />Co356716(g ryoMy CoJul 21, 2023(Print, Type, or Stamp Commissioned Name of Notary Public <br />Bonded thrNotary Assn. <br />Ci who is personally known to me or ❑ who has produced <br />as identification. <br />* * END OF SECTION * * <br />00452-2 <br />F:\PublieWorks\ENGINEERING DIVISION PROJECTS\1638 6th Avenue US -1 to 21st Street Resurfacing (SCOP)\1-Admin\Bids\Bid <br />Documents\Master Contract Documents\00452 Disclosure of RelationshipsAnc <br />