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t_ .1 <br /> e _ <br /> 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 /> t "asy <br /> 1 . This sworn statement is submitted with RFP No , 41M for <br /> u /ISSETS � IUtL. b Fv ; UP_ � 5 (hlLbje& Vs � SFWyiovs & V ) san_ %( CoMo1 { 'TT S , <br /> 2 . This sworn statement is submitted by: <br /> ( Name of entity submitting Statement ) <br /> whose business address is : <br /> `%lS� q-)w cF, �'�, o Be ,4c+1 ' FL 3 .3 ie, , and <br /> ( if applicable ) <br /> its Federal Employer Identification Number ( FEIN ) <br /> is Lo3ia97s- 2z <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 <br /> ( Please print name of individual signing ) <br /> and my relationship to the entity named above is <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 /> XII <br />