Laserfiche WebLink
<br />. <br /> <br />. <br /> <br />. <br /> <br />6. <br /> <br />Based on information and belief, the statement which I have marked below is true in relations to the entity <br />submitting this sworn statement. (Indicate which statement applies.) <br /> <br />. Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, <br />shareholders, employees, members, or agents who are active in the management of the entity, nor any <br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, <br />1989. <br /> <br />o The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, <br />shareholders, employees, members, or agents who are active in the management of the entity, or an <br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, <br />1989. <br /> <br />o The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, <br />shareholders, employees, members, or agents who are active in the management of the entity, or an <br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, <br />1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of <br />Florida, Division of Administrative Hearings and the final Order entered by the hearing Officer <br />determined that it was not in the public interest to place the entity submitting this sworn statement on the <br />convicted vendor list (attach a copy of the final order). <br /> <br />I UNDERST AND THAT THE SUBMISSIONOF THIS FORM TO THE CONTRACTING OFFICER FOR THE <br />PUBLIC ENTITY IDENTIFIED IN PARAGRAPH I ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND <br />THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS <br />FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO <br />ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUTN PROVIDED IN SECTION <br />287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION <br />CON D IN S FORM <br /> <br /> <br />Francisco A. Norona, President <br />(Printed or Typed Legal Name of Affiant) <br /> <br />State of Florida <br /> <br />Broward <br /> <br />County of <br /> <br />Sworn to and subscribed before me this <br /> <br />10th <br /> <br />, 2007 by <br /> <br />September <br /> <br />day of <br /> <br />Francisco A. Norona, President <br /> <br />Lind, S. S'ot", ~,Lv !l~ <br />Notary's Name Printe ,Stamped or Typed <br /> <br />Notary Seal: <br /> <br />. <br />:~r-:,~'"~lfl"" <br /> <br />~lf:t~1:~ <br />t ~.J!!;"Q~ <br />'t! .'~i:;{f"~~:-'~ <br />fl. ".......,. <br /> <br />UNDA s. SCOTECE <br />MY COMMISSION # DO 240707 <br />EXPIRES: December 13, 2007 <br />Bonded Thill Notary P~lic UndelWl1ters <br /> <br />Personally Known: X <br />Identification Produced <br /> <br />Or Produced Identification <br />