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<br /> ATLANOV, LLC
<br /> PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01
<br /> Public Entity Crimes
<br /> market 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 pudic entity gime 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(1Xe), 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 /> V 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 /> 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 /> shaareholders, 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 pudic 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 Hearig 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 swan 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 /> 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 ANY.CHANGE IN THE INFORMATION CONTAINED IN THIS FORM
<br /> ft
<br /> (Signature) f
<br /> Dens Atlanov ill, 41((A442V
<br /> (Printed Name)
<br /> CEO and President
<br /> (Title) /1 !
<br /> Sworn to and subscribedbefore me this I(� day of ! ` r`1 ,20d_by
<br /> NTmtnig a�ilE)
<br /> _hitt notary u tic •State of Florida
<br /> Commission• FF 933386 y
<br /> Signature:Notary Jnc-State of Florida
<br /> '„F...�.•a` My Comm. Expires Jan 21.2020 � l..Ltlt GLOr " 'r-
<br /> "'•°f,�,t„^ Bonded through National Notary Assn. Print or Type Cammssorhed Name
<br /> Personally Known _ _ _ OR Produced Identification V
<br /> Type of Identification Produced Oil- A?Iii
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