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market value under up arm's length agreement, shall be a prime facie case that one person
<br />controls analher person. A person who knounngly enters into a joint ventufe with a person who
<br />has been convicted of a public entity crime in Florida during the preceding 36 months shall be
<br />considered an affiliate,
<br />5. 1 understand that a "person" as defined in Pars. 287,133(1)(e), Florida Statutes, means any aalural
<br />person or entity grganized under the laws of any state or of the United States with the legal power to
<br />enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or
<br />services let by a public entily, or which othenvise transacts or'applies to transact business with a pvblie
<br />entity. The terra "persons" includes those offrgers, directors, executives, partners, shareholders,
<br />emnfnyaes, rnernburs, and agents who are active in rnaw 3gement of any wily.
<br />Rased on information and belief, the statement which I have marked belvar is true in relaSun to the eritity
<br />zubrnitting thir, sworn statement_ (Indicate which statement applies-)
<br />x Neither the entity submitting this sworn statement, not any of it's officers, dirc+rtors, executives, partners,
<br />shareholders, employees, members, or agents who are active in the management of the entity, nos arty
<br />affiliate of the entity has been charged with and.coavicted. of a pubiie entity crime subsequent to July, 1,.
<br />The entity submitting This sworn statement, or one or more of its officers, d1reatore, exbculives, partners.
<br />shareholders, employees, members, or agents who are active in the management o.` the enfibi, or an
<br />affiliate of the entity Figs bean chargedd'with and convicted of a public entity crime subsequent t+� July 1,
<br />1989.
<br />The entity svbmitting this sworn statement; or one or more of Its officers, directors, executes, partners,;
<br />shareholders. employees, members, or agents who are active in the managerrlenl of the entity, or an
<br />affiliate of the entity has been .charged with and convicted of a public entity crime subsequent to July 1,
<br />19",, However, there has been a subsequent proceeding before a Hearing Officer of the State of
<br />Florida, Division of Administrative Iearing& and the Filial Order entered by the Hearing Offioer of the
<br />Stale of Florida, Division of 'Administrative Hearings and the Fiaal Order enteredby the Hearing Officer
<br />determiriad that it was not in•the public interest to place the'entity submitting this sworn statement ❑n the
<br />oonvicted vendor Itst. (Attach A copy of the final order,)
<br />I UNDERSTAND THAT THE SUBMISSION OF TH15 FORM TO THE CONTRACTING OFFICER FOR THE
<br />PUBLIC ENTITY IDENTIFIED IN PARAGRAPH i (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONO( AND,
<br />THAT THIS FORM IS VAUD THROUGH DECEMBER 31 OF THE CALENDAR YEAR Ifd'iM1!'HICH IT IS FILED. I.
<br />ALSO UNDERSTAND THAT•I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR.TO ENTERING INTO
<br />A CONTRACT IN EXCESS or- THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
<br />STATUTES, FOR CATEGORY 1 WO OF ,ANY, CHANGE IN THE INFOERMATION' CONTAINED IN THIS FORM..
<br />By. n, •
<br />(Si
<br />qveven Glenn
<br />(Printed Name
<br />kAM PresitlAn
<br />(Title)
<br />Sworn to and subscribed before me this �' day of� 20 , by
<br />(/AFFIX NOTARY STAMP HERE)
<br />BAIANNA L. MO1 E pt
<br />ftataryPuh�r�l�elsleit�'ewYorh St luxe: Flutary PublF -State ofFrFesr�Ca.� (%
<br />A?yi:armiasldn LtFlres Ose, 23, 20 °" •• ,
<br />Ptint a Comitr stoned ame
<br />Peesanal:y Itnovrrt -- r%,j OR Ptodiij qd Identification _
<br />Type of Identifica,ion Produced in
<br />3orio
<br />I,
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