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CITY OF SUNNY ISLES BEACH <br />PARKS/MEDIANS/RIGHT-OF-WAY MAINTENANCE <br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) <br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES <br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY <br />PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. <br />1. This sworn statement is submitted to n Ad 9 /c Lo✓ <br />by lrCE. <br />whose business address is , f Ye2V Al -w, `V 41- 9, <br />�/ol/c/uJEaocr, /C-�/ 3 30d- V-- <br />and (if applicable) its Federal Employer Identification Number (FEIN) is (IF the <br />entity had no FEIN, include the Social Security Number of the individual signing this sworn <br />statement: <br />2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida <br />Statutes, means a violation of any state or federal law by a person with respect to and <br />directly related to the transaction of business with any public entity or with an agency or <br />political subdivision of any other state or with the United States, including, but not limited <br />to, any bid or contract for goods or services to be provided to any public entity or an agency <br />or political subdivision of any other state of the United States and involving antitrust, fraud, <br />theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. <br />3. I understand that "convicted' or "conviction" as defined in Para. 287.133(1)(b), Florida <br />S tutes, means a finding of guilt or a conviction of a public entity crime, with or without <br />an adjudication of guilt, in any federal or state trail court of record relating to charges <br />brought by indictment or information after July 1,1989, as a result of a jury verdict, nonjury <br />trial, or entry of a plea of guilty or nolo contendere. <br />4. I understand that an "affiliate" as defined in Para. 287.133(lxa), Florida Statutes, means: <br />1. A predecessor or successor of a person convicted of a public entity crime; or <br />2. Any entity under the control of any natural person who is active in the management of the <br />entity and who has been convicted of a public entity crime. The term "affiliate" includes <br />those officers, directors, executors, partners, shareholders, employees, members, and agents �,�� <br />