|
Imarket 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 /> I has been convicted of a public entity crime in Florida during the preceding 36 months shall be
<br /> considered an affiliate.
<br /> I 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 /> I 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 /> I 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 /> I
<br /> X 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 /> I 1989.
<br /> X 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 /> I 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 /> I 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 • n statement on the
<br /> convicted vendor list. (Attach a copy of the fin- • •-r.)
<br /> I UNDERSTAND THAT THE SUBMISSION o THIS F•RM TO TH ' •NTRACTING OFFICER FOR THE
<br /> PUBLIC ENTITY IDENTIFIED IN PARAG" •H 11.1 (O""E) ABOVE : OR THAT PUBLIC ENTITY ONLY AND,
<br /> THAT THIS FORM IS VALID THROUGH,. EMBE' 31 OF T.' CALENDAR YEAR IN WHICH IT IS FILED. I
<br /> ALSO UNDERSTAND THAT I AM RE• ' . TO 'FORM E PUBLIC ENTITY PRIOR TO ENTERING INTO
<br /> I A CONTRACT IN EXCESS OF TH ,1 H' D Al •UNT PROVIDED IN SECTION 287.017, FLORIDA
<br /> STATUTES, FOR CATEGORY TWO 4( ,' p ANe IN THE INFORMATION CONTAINED IN THIS FORM.
<br /> By. Jk*
<br /> Icy P
<br /> I
<br /> .�' • Sto
<br /> /'b'Pintars
<br /> ladle),
<br /> dea[ne)
<br /> nt
<br /> I
<br /> Sworn to - • s 6• .cri.—
<br /> e•�before me this day of r ' "�\ , 20 �/ , by
<br /> -
<br /> Nallir
<br /> (AFFIX NOTARY STAMP HERE)
<br /> WANDA QUINT: A Signatuu Mo Pubal State of Florida
<br /> I n MY COMR SS10N' ,280130? V't
<br /> EXPIRES: 30.2012 Print or Type Commissioned Name
<br /> , 3.sc Imn Ft Sr 'DisNU111 Assoc.Co.
<br /> IPersonally Known allie OR Produced Identification
<br /> Type of Identification Produced .
<br /> 1 10/1998 3 of 7
<br />
|