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<br />6. Based on information and belief, the statement which I have marked below is true in <br />relation to the entity submitting this sworn statement. [Indicate which statement applies] <br /> <br />Neither the entity submitting this sworn statement, nor any of its officers, <br />directors, executives, partners, shareholders, employees, members, or agents who are <br />active in the management of the entity, nor any affiliate of the entity has been charged <br />with and convicted of a public entity crime subsequent to July 1, 1989. <br /> <br />The entity submitting this sworn statement, or one or more of its officers, <br />directors, executives, partners, shareholders, employees, members, or agents who are <br />active in the management of the entity, nor any affiliate of the entity has been charged <br />with and convicted of a public entity crime subsequent to July 1, 1989. <br /> <br />The entity submitting this sworn statement, or one or more of its officers, <br />directors, executives, partners, shareholders, employees, members, or agents who are <br />active in the management of the entity, nor any affiliate of the entity has been charged <br />with and convicted of a public entity crime subsequent to July 1, 1989. However, there <br />has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division <br />of Administrative Hearings and the Final Order entered by the Hearing Officer of the State <br />of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing <br />Officer determined that it was not in the public interest to place the entity submitting this <br />sworn statement on the convicted vendor list. [attach a copy of the final order] <br /> <br />I UNDERSTAND THAT THE "SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR <br />THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY <br />ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN <br />WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC <br />ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT <br />PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY HANGE <br />IN THE INFORMATION CONTAINED IN THIS FORM. <br /> <br /> <br />Sworn to and subscribed before me this <br /> <br />11 <br /> <br />day of /vi 0 <br />cor- <br />.1 <br />~ <br /> <br />I 20 08' <br /> <br />Personally known / <br /> <br />OR Produced identification -c)l <br /> <br />N t P ~rru""-c!'_\?~-l'."'.~I"""""""I1I"" <br />o a ry u'! l; - .;)l-.<;\,);fil,Q IGARCIA : <br /> <br />: ~",\~~I;~I"" Comm1: 000442135 : <br />: N'~"":~~~ Expire. 6/19/2009 : <br /> <br />My C m .: ~ -<'~~';x: .k"',l]d'i-d Ihru (800)4:J2-4254E <br />o mlJiul< :;"~Il~~ fJlFI~riaa No,<>or"_' Ao:cn Int'! : <br />I............... II...... II II ....... ........N& <br /> <br />(Type of identification) <br /> <br />(Printed typed or stamped <br />commissioned name of notary public) <br /> <br />04/08 <br /> <br />00402-2 <br /> <br />06-5723 <br />