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0 market value under an arm's length agreement, shall be a prime facie case that one person
<br /> controls another person. A person who knowingly enters into a joint venture 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 /> • 11.5. I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural
<br /> • person or entity organized 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 entity, or which otherwise transacts or applies to transact business with a public
<br /> ® entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
<br /> employees, members, and agents who are active in management of any entity.
<br /> ® 11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity
<br /> ® submitting this sworn statement. (Indicate which statement applies.)
<br /> X Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners,
<br /> ® shareholders, employees, members, or agents who are active in the management of the entity, nor any
<br /> ® affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
<br /> 1989.
<br /> •
<br /> • The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
<br /> shareholders, employees, members, or agents who are active in the management 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 /> • 1989.
<br /> • The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
<br /> ® shareholders, employees, members, or agents who are active in the management 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 /> • 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of
<br /> Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the
<br /> • State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer
<br /> • determined that it was not in the public interest to place the entity submitting this sworn statement on the
<br /> convicted vendor list. (Attach a copy of the final order.)
<br /> •
<br /> • I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
<br /> PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
<br /> • THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH 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 OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
<br /> • STATUTES, FOR CATEGORY TWO OF ANYr HANGE IN THE INFORMATION CONTAINED IN THIS FORM.
<br /> • By:
<br /> • (Signature
<br /> Dennis J. Giordano
<br /> • (Printed Name)
<br /> President
<br /> • (Title)
<br /> • t
<br /> Sworn to d subscribed before me this ) day of 0(� / , 20 / , by
<br /> •
<br /> ,Sworn to
<br /> l�/J
<br /> • (AFFIX N TTAAW F L V I
<br /> ® 37(
<br /> caflgSSION 0 EE002877 \\\
<br /> ®
<br /> SPIRES B212014 Signature; NNotta�ry�Pu lid—State of Florida
<br /> ®� ees
<br /> ao�oav, «arAar, n L
<br /> i"1 vans
<br /> • Print or Type Commissioned Name
<br /> • Personally Known U OR Produced Identification
<br /> • Type of Identification Produced
<br /> 0
<br /> 10/1998 3of7
<br />
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