|
I .
<br /> J Bonfill&Associates
<br /> RFQ#12-04-02 Page 119
<br /> Imarket value under an arm's length agreement, shall be a prime fade 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 /> Iconsidered 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 /> I
<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 /> I11.6. 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 /> I /r 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 /> IThe 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
<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 /> 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 /> State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer
<br /> I 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 /> I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
<br /> I 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 /> ISTATUTES, FOR CATEGORY TWO OF ANY,CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
<br /> By: (444/ 114‘ �' C
<br /> (S ,duef
<br /> ' CO ELRJE 13OUJFILL GEE
<br /> (Printed Name)
<br /> 'FR ES lnQ-f.
<br /> I
<br /> )T
<br /> (Title)
<br /> Sworn to,and subscribed before me this .3 day of Apr/ l ,20) , by
<br /> J'Cc9He/In-t an 71 eel-
<br /> 1 1, gaggijit0
<br /> "tl""Ly., CATHERINE A.SMITH
<br /> �C
<br /> I
<br /> 1 =° \ �` Notary Fabric•State ol Florida I Signature: Notary PublicState of Florida
<br /> se • My Comm.Expires Jan 24,2015 I G�rrh:•vi n L iSfi i' f h
<br /> `k; a,, Commission s EE 57675 I Print or Type Commissioned Name
<br /> Personally Known X OR Produced Identification
<br /> I
<br /> Type of Identification Produced
<br /> 10/1958 3017
<br /> I
<br /> I .
<br />
|