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<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
<br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
<br />
<br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />OFFICIAL AUTHORIZED TO ADMINISTER OA HIS.
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<br />1. This swom statement is submitted to Ci ty of Sunny Isles beach
<br />[print namc of the public entity]
<br />byBret J. Abraham Manaqer Systems Sales SW Florida
<br />[print individual's name and title]
<br />furADT Security Services, Inc.
<br />[print namc of cntity submitting swom statement]
<br />
<br />whose business address is
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<br />7747 NW 48th Street, Building D, Suite 160
<br />Miami FL 33166
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<br />and (if applicable) its Federal Employcr Identification Numbcr (FEIN) is 5 8 -1 8141 02
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<br />(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statemcnt: .)
<br />
<br />2. I understand that a "public entity crime" as defined in Paragraph 287.l33(I)(g), Florida Statutes, means a
<br />violation of any statc or federal law by a person with respect to and directly relatcd to the transaction of
<br />business with any public entity or with an agcncy or political subdivision of any other state or of the Unitcd
<br />States, including, but not limitcd to, any bid or contract for goods or services to be provided to any public
<br />entity or an agency or political subdivision of any other state or of the United States and involving antitmst,
<br />fraud, theft, bribery, collusion, racketeering, conspiracy, or material misreprcsentation.
<br />
<br />3.
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<br />I undcrstand that "convicted" or "conviction" as dcfined in Paragraph 287.13J(I)(b), Florida Statues, means a
<br />finding of guilt or a conviction of a public cntity crime, with or without an adjudication of guilt, in any fedcral
<br />or state trial court of record relating to charges brought by indictment or information aftcr July 1, 1989, as a
<br />rcsult of a jury vcrdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
<br />
<br />4. I understand that an "affiliate" as defined in Paragraph 287.l33(1)(a), Florida Statutes, means:
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<br />I. A predeccssor or successor of a person convicted of a public entity crime; or
<br />2. An cntity under the control of any natural person who is activc in the managcmcnt of thc entity and who
<br />has becn convicted of a public entity crime. The tenll "affiliate" includes those officers, directors, executives,
<br />partl1crs, sharcholdcrs, cmployccs, mcmbcrs, and agcnts who arc active in the managemcnt of an affiliatc.
<br />The ownership by onc pcrson of shares constituting a controlling interest in another person, or a pooling of
<br />cquipment or income among persons when not for fair markct value under an aml's length agreement, shall be
<br />a prima facie casc that one pcrson controls another person. A pcrson who knowingly enters into a joint
<br />vcnturc with a person who has been convicted of a public cntity crimc in Florida during thc prcceding 36
<br />months shall bc considcred an affiliatc.
<br />
<br />5. I understand that a "person" as defined in Paragraph 287.133(I)(c), Florida Statutes, means any natural
<br />pcrson or entity organizcd undcr the laws of any state or of thc United States with the Icgal power to cntcr
<br />into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let
<br />by a public entity, or which othcrwise transacts or applies to transact business with a public cntity. Thc tcnll
<br />"pcrson" includcs those officers, directors, executivcs, partners, shareholders, cmployees, members, and
<br />agcnts who arc activc in managemcqt of an entity.
<br />
<br />Form PUR 7068 (Rev. 06/11/92)
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<br />00402-1
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<br />SIB
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