Laserfiche WebLink
<br />A'ITACBMENT 2 <br /> <br />SWORN STATEMENT PURSUANT TO SECTION 287.133 (3) (a), <br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES <br /> <br />TIllS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR <br />OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS <br /> <br />1. This sworn statement is submitted to Miami-Dade County <br /> <br />by ~'IC~ (.o\I\~e\r) C;+'I M(\V\,,~cy- <br />(print individual's name and title) <br />for C,.\ 'I of SU.~\IY l:5\ e~ Bea c~ . <br />(print Name of entity submitting sworn statement) <br />whose business address is \8010 (0\ \i~'fS A\X:; SUI,\Vl.Y ls\tt \Je.ach} FL 3JJ(() <br /> <br />and if applicable its Federal Employer Identification Number (FEIN) is (; 5 -0784 b 4 t7 <br />If the entity has no FEIN, include the Social Security Number of the individual signing <br />this sworn statement: <br /> <br />2. I un,derstand that a "public entity crime" as defined in paragraph 287.133 (l)(g), Florida Statutes. <br />means a violation of any state or federal law by a person with respect to and directly related to the <br />transactions of business with any public entity or with an agency or political subdivision of any other <br />state or with the United States, including, but not limited to, any bid or contract for goods or services <br />to be provided to public entity or agency or political subdivision of any other state or of the United <br />States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material <br />misinterpretation. <br /> <br />3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133 (1)(b), Florida <br />Statutes. means a finding of guilt or a conviction of a public entity crime, with or without an <br />adjudication of guilt, in any federal or state trial court of record relating to charges brought by <br />indictment or information after .July 1, 1989, as a result of a jury verdict, non jury trial, or entry of a <br />plea,~f guilty or nolo contendere. <br /> <br />4. I understand that an "aff....liate" as defined in paragraph 287.133(1)(a), Florida Statutes. means: <br />'1. A predecessor or successor of a person convicted of a public entity crime; or 2. An entity under <br />the control of any natural person who is active in the management of the entity and who has been <br />convicted of a public entity crime. The term "afl1.1iate" includes those officers, directors, <br />executives, partners, shareholders, employees, members, and agents who are active in the <br />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 <br />market value under an arm's length agreement, shall be a prima facie. case that one pers~n <br />controls another person. A person who knowinglyeilters 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 />considered an affiliate. . <br /> <br />13 of 16 <br /> <br />dIe <br />