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2022-075A
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2022-075A
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Last modified
7/7/2022 3:16:34 PM
Creation date
7/7/2022 1:03:33 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
04/12/2022
Control Number
2022-075A
Agenda Item Number
12.G.2.
Entity Name
Proctor Construction Company, LLC
Subject
North County Library Expansion
Project Number
IRC-2009
Bid Number
2022021
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X The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, <br />shareholders, employees, members, or agents, who are active in management of the entity have the <br />following relationships with a County Commissioner or County employee: <br />Name of Affiliate Name of County Commissioner Relationship <br />or entity or employee <br />John Granath John Granath III (IRCFR) Father / Son <br />John ath (Signature) <br />March S, 2022 <br />(Date) <br />STATE OF Florida <br />COUNTY OF Indian River <br />Sworn to (or affirmed) and subscribed before me by means of a physical presence or ❑ online <br />notarization, this 84b day of_Vpxr-k-j_, 20 22 , by John Granath <br />(name of person making statement). <br />(Sig atu of Notary Public - State of Florida) <br />(Print, Type, amp Commissioned Name of Notary Public) <br />2"'who is personally known to me or ❑ who has produced <br />as identification. <br />SARAH E TESTA <br />Notary Public State o} j <br />Commission # GG 958 <br />f' My Comm. Expires Feb 2 <br />Bonded through National Nota <br />Sworn Statement of Disclosure of Relationships - 00452-2 <br />I'APublic WorksIENGINEERING DIVISION PROJECTS\2009 North County Library Addition\t-AdmiMBidslBid Documents\DIV 02 Bidding Documents.docx <br />
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