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<br /> PUBLIC ENTITY CRIMES
<br /> City of Sunny Isles Beach
<br /> ' J or 18070 Wane Avenue
<br /> ''•r �� Sunny islue Beech.Fl 33160
<br /> go.' Telephone:(305)947-0606 Fax(305)949-3113
<br /> SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br /> FLORIDA STATUTES,ON PUBLIC ENTITY CRIMES
<br /> PUBLIC ENTITY CRIMES
<br /> Pursuant to the provisions of paragraph (2)(a)of Section 287.133, Florida State Statutes-"A person or affiliate
<br /> who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a
<br /> Bid on a Contract to provide any goods or services to a public entity,may not submit a Bid on a Contract with a
<br /> public entity for the construction or repair of a public building or public Work,may not submit Bids on leases of
<br /> real property to a public entity, may not be awarded to perform Work as a Contractor,supplier,Sub-Contractor,or
<br /> Consultant under a Contract with any public entity,and may not transact business with any public entity in excess
<br /> of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on
<br /> the convicted vendor list'.
<br /> THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br /> OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br /> 11,1, This sworn statement Is submitted to City of Sunny isles Beach
<br /> by Juan Barreneche,Vice President
<br /> [pant Indfwduare name end hue(
<br /> for Southern Underground Industries,Inc.
<br /> (pal name of(mkty submuung sworn Valmont)
<br /> whose business address is:
<br /> 3453 NW 44 St,Suite 205,Oakland Park,FL 33309
<br /> and(if applicable)Its Federal Employer identification number(FEIN)is 26-2521235
<br /> (If the entity had no FEiN, include the Social Security Number of the individual signing this sworn
<br /> statement .)
<br /> 11.2. I understand that a"public entity crime°as defined in Paragraph 287.133(1)(g), Florida Statutes,means a
<br /> violation of any state or federal law by a person with respect to and directly related to the transaction of
<br /> business with any public entity or with an agency or political subdivision of any other state or with the
<br /> United States,including,but not limited to,any Bid or Contract for goods or services to be provided to any
<br /> public entity or an agency or political subdivision of any other state of the United States and involving
<br /> antitrust,fraud,theft,bribery,collusion, racketeering,conspiracy,or material misrepresentation.
<br /> 11.3. I understand that"convicted°or°conviction"as defined in Pare. 287.133(1)(b), Florida Statutes,means a
<br /> finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any
<br /> federal or state trail court of record relating to charges brought by Indictment or information after July 1,
<br /> 1989,as a result of a jury verdict,non-jury trial,or entry of a plea of guilty or nolo contendere.
<br /> 11.4. I understand that an"affiliate°as defined in Para.287.133(1)(a), Florida Statutes, means:
<br /> a.) predecessor or successor of a person convicted of a public entity crime;or
<br /> b.) Any entity under the control of any natural person who is active in the management of the entity
<br /> and who has been convicted of a public entity crime. The term"affiliate°includes those officers,
<br /> directors, executors, partners,shareholders, employees, members,and agents who are active in
<br /> the management of an affiliate. The ownership by one person of shares constituting a controlling
<br /> interest in another person, or a pooling of equipment or income among persons when not for fair
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