Docusign Envelope ID: 57BA4B2A-6E80-451F-8F28-6EFB63E1FA7C
Address of Business Entity:
Nature of the regulation of the Entity by the Duchesne County (including any licenses, permits, etc.):
Jerry D. Allred and Assoc. Inc.
1235 N 700 E
Duchesne, Ut. 84021
Professional Land Surveyor.
Nature of the business which the Entity does or anticipates doing with the Duchesne County:
Land Surveying and Consulting, along with performing duties of the County Surveyor according to State code for the County.
Nature of the transaction involving the Duchesne County for which you may receive or agree to receive compensation from the Entity for assisting, including a description of the services to be performed and the compensation to be rendered:
Land Surveying and Consulting, along with performing duties of the County Surveyor according to State code for the County.
DISCLOSURE OF OTHER PERSONAL INTERESTS
Please disclose any other personal interest or investment which creates or has the appearance of creating a conflict between your public duties and your personal interests.
Name of the Business Entity or Person: * (Write NA if not applicable.)
Address of Business Entity or Person:
NA
Principal Activity Engaged in by Entity:
Nature of Investment or Involvement: