|
<br />ATTACHMENT B
<br />
<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 OFFICIAL AUTHORIZED TO
<br />ADMINISTER OATHS.
<br />
<br />1 . This sworn statement is submitted to City of Sunny Isles Beach
<br />by William G. Benson, C,P.A., Partner
<br />for Keefe, McCullough & Co., LLP, C,P.A.'s,
<br />
<br />whose business address is:
<br />
<br />6550 North Federal Highway, Suite 410
<br />Fort Lauderdale, Florida 33308
<br />
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 59-1363792,
<br />
<br />(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement:
<br />N/A )
<br />
<br />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 the United
<br />States, including, but not limited to, any bid or contract for goods and services to be provided to any public
<br />entity or an agency or political subdivision of any other state or of the United States involving antitrust, fraud,
<br />theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation,
<br />
<br />3, I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a
<br />finding of guilt or a conviction or a pUblic entity crime, with or without an adjudication of guilt, in any federal
<br />or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a
<br />result of a jury verdict, nonjury trial. or entry of a plea of guilty or nolo contendere.
<br />
<br />4, I understand that an "affiliate" as defined in Paragraph 287,133(1 )(a), Florida Statutes, means:
<br />
<br />a. A predecessor or successor of a person convicted of a public entity crime; or
<br />
<br />b. An entity under the control of any natural person who is active in the management of the entity and
<br />who has been convicted of a public entity crime. The term "affiliate" includes those officers,
<br />directors, 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 interest
<br />in another person, or a pooling of equipment or income among persons when not for fair market
<br />value under an arm's length agreements, shall be a prima facie case that one person controls
<br />another person. A person who knowingly enters into a joint venture with a person who has been
<br />convicted of a pUblic entity crime in Florida during the preceding 36 months shall be considered an
<br />affiliate,
<br />
<br />5, In understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural
<br />person or entity organized under the laws of any state or of the United States with the legal power to enter
<br />into a binding contract and which bids or applies to bid on contracts for the provision of goods or services
<br />led by a public entity, or which otherwise transacts or applies to transact business with a public entity. The
<br />term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and
<br />agents who are active in the management of an entity.
<br />
<br />6, Based on information and belief, the statement that I have marked below is true in relation to the entity
<br />submitting this sworn statement (Indicated which statement applies.)
<br />
<br />---X (1) Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners,
<br />shareholders, employees, members, or agents who are active in the management of the entity, not any
<br />affiliate of the entity, has been charged with and convicted of a public entity crime subsequent to July 1,
<br />1989,
<br />
|