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t SUr N Y +!!FJ <br />PUBLIC ENTITY CRIMES <br />` - City of Sunny Isles Beach <br />',� -. ti • e° TWO Collins Avenue <br />`. +�•rcfl*` +�Smnyls7esBesr]ti,FL 33150 <br />'• <br />40 U.- •Telephane: (306) 94 1-43606 Fax: (305) W4u-3113 <br />SWORN STATEMENT PURSUANT TO SECTION 287,133(3)(x) <br />FLOIIUDA STATUTES, ON PUBLIC ENTITY CRIMES <br />PUBLIC ENTITY CRIMES <br />Pursuani to the provisions of paragrapn (2) (a) of Section 781.133, rlorida State Statutes - "A person or affiliatK <br />who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a <br />¢id on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a <br />public entity for the Construction or repair of a public building or public Work, may not submit Bids on leases of <br />real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub -Contractor, or <br />Consultant under a Contract with any public entity, and may not transact business with any public entity in excess <br />of the threshold amount Category Two of Sec, 257,017, FS for thirty six months from the date of being placed on <br />the convicted vendor Ill st", <br />THIS FORM MUST BE SIGHED AND SWORN TO IN THE PRESENCE OF A "OTARY `3UBLI11 OR OTHER <br />OFFICIAL AUTHORIZED TO ADMINISTER OATHS. <br />1. This sworn statement is submitted to City of Sui1nyr isles Beach <br />by John Ramsayr President & CEO <br />[prim individuerx rainy and GOet <br />for CfowderGuIf Joint Venture, Inc. <br />Lirinl nae! Of e+l'?ly sdhmildirg awarn SULememl <br />whose business address is, <br />5435 Bus1ne55 Parkway Theodore, AL 36582 <br />and (if applicable) its Federal Employer Identification number (FEIN) is 01-0626019 _ <br />(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn <br />statement; I <br />2.-' 1 understand that a "public entity crime" as defined in Paragraph 287.133(1)(9), Florida Stature% means e <br />violation of any state or federal law by a person with respect to and directly related to the transaction of <br />business with any public entity or with an agency or political subdivision of any other state or witl3 the <br />United States, indudng, but not limited to, any Bid or Contract for goods or services to be provided to any <br />public entity -or an agency or political subdivision of any other state of the United States and involving <br />antitrust, fraud, theft, bribery, CpAusicn, racketeering, conspiracy. or material misrepresentation_ <br />3. 1 understand that "convicted" or "conviction" as defined in Para. 287.133(1)(b), Florida Statutes., means a <br />finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any <br />federal or state trail court of record relating to charges brought by indictment or information after July 1, <br />1989, as a result of a jury verdict, non -jury trial, or entry of a plea of guilty or nolo contendere. <br />d_ 1 understand that an "affiliate" as defnpd in Para. 287.133(1)(a), Florida Statutes, means: <br />a.) predecessor or successor of a person convicted of a public entity chnie; or <br />b.) Any entity under the control of any natural person who is active in the management of the entity <br />and who has been convicted of a public entity crilme, The term "affiliate' includes those officers, <br />directors, executors, tIARnBrS, sharehatders, employees, members, and agents who are active in <br />the management of an affiliate. The ownership by one person of shares constituting a controlling <br />interest in another person, or a pooling of equipment or income among persons when not for fair <br />2 of 113 <br />