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SWORN STATEMENT UNDER SECTION 105 . 08 , <br /> INDIAN RIVER COUNTY CODE , ON DISCLOSURE OF RELATIONSHIPS <br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC <br /> OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS . <br /> 1 . This sworn statement is submitted with RFP No . 5054for <br /> " Children in Slots " and " Psychological Services " for 2003-2004 <br /> 2 . This sworn statement is submitted by : <br /> Community Child Care Resources Inc. <br /> ( Name of entity submitting Statement) <br /> whose business address is : <br /> Not for Profit and <br /> ( if applicable) <br /> its Federal Employer Identification Number ( FEIN ) is 65- 0523165 <br /> ( If the entity has no FEIN , include the Social Security Number of the individual <br /> signing this sworn statement <br /> 3 . My name is Barbara J . Patten <br /> ( Please print name of individual signing ) <br /> and my relationship to the entity named above is Executive Director <br /> 4 . 1 understand that an " affiliate " as defined in Section 105 . 08 , Indian River <br /> County Code , means : <br /> The term " affiliate" includes those officers , directors , executives , partners , <br /> shareholders , employees , members , and agents who are active in the <br /> management of the entity . <br /> 5 . 1 understand that the relationship with a County Commissioner or County <br /> employee that must be disclosed as follows : <br /> XII <br />