Laserfiche WebLink
ob <br />4" <br />this sworn statement. (please indicate which statement <br />applies). � <br />x Neither the entity submitting this sworn staterment, nor any <br />officers, directors, executives, 'partners, shareholders, <br />employees, members, or agents who are active in management <br />of the entity, have any relationships as defined in Section <br />105.08, Indian River County Code, with any County <br />Commissioner or County employee. <br />_ The entity submitting this sworn statement, or one or more <br />—'- of the officers, directors, executives, partners, <br />shareholders, employees, members, or agents who are active <br />in management of the entity have the following relationships <br />with a County Commissioner or County employee. <br />Name of Affiliate Name of County Reiationshi <br />Dr Rntit Commissioners <br />Edwin 1�. U-pthegrove, President <br />February 2, 1999 <br />(Date) <br />STAXE OF Florida <br />COUM 08' Brevard <br />The :foregoing instrument was acknowledged before ms this 2pd,,, day <br />of February , 19 99 , by Es , who is <br />personally known to we or who has produced <br />as identification. . <br />C` c3TARY PfTBL <br />pR.W: Dorothy_ J Dilbeck <br />STATE OF FLORIDA AT JARGE <br />r(r rrrrrrrrr,, rrrrr� r rr.+r.+rrr�rarrr�rr� r <br />5 <br />>4 cl Dorothy J. Dil beck <br />>� " NOUry fl:hlic, 5 <br />>� o, r' M CommCQM T11 s ssion Pte ` <br />ion <br />ENi? OF SEC'PICt� a m¢r�aot. <br />00310"12 >irrr rrrhirri�r'rir°r`°�'iY c°s fu�a„�r,'rr/ <br />