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<br />- <br /> <br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY <br />PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OAHTS. <br /> <br />1. This sworn statement is submitted to <br /> <br />City of Sunny Isles Beach <br /> <br />by Javier F. Salman, AlA, LEED AP <br />for Corzo Castella Carballo Thompson Salman, P.A. (C3TS) <br />whose business address is 901 Ponce de Leon Blvd, Suite 900 <br />Coral Gables, Florida 33134 <br />and (if applicable) its Federal Employer Identification Number (FEIN) is <br /> <br />65-0039493 <br /> <br />(IF the entity had no FEIN, include the Social Security Number of the individual signing this sworn <br />statement: <br /> <br />2. I understand that a "public entity crime" as defined in Paragraph 287.133(1 )(g), Florida <br />Statutes, means a violation of any state or federal law by a person with respect to and directly <br />related to the transaction of business with any public entity or with an agency or political <br />subdivision of any other state or of the United States, including, but not limited to, any bid or <br />contract for goods or services to be provided to any public entity or an agency or political <br />subdivision of any other state or of the United States and involving antitrust, fraud, theft, <br />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 <br />Statues means finding of guilt or 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, nonjury trial, or <br />entry of a plea of guilty or nolo contenders. <br /> <br />4. I understand that an "affiliate" as defined In Paragraph 287.133(1)(a), Florida Statues, means: <br /> <br />a. A predecessor or successor of a person convicted of a public entity crime; or <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 come. The term "affiliate" includes those officers, <br />director, 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 and arm's length agreement, shall be a prima facie case that one person <br />controls another person. A person who knowingly enters into a joint venture with a person who has <br />been convicted of a public entity crime in Florida during the preceding 36 months shall be <br />considered an affiliate. <br /> <br />5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means <br />any natural person or entity organized under the laws of any state or of the United States <br />with the legal power to enter into a binding contract and which bids or applies to bid on <br />contracts for the provision of goods or services let by a public entity, or which otherwise <br />transacts or applies to transact business with a public entity. The term "person" includes <br />those officers, directors, executives, partners, shareholders, employees, members, and <br />agents who are active in the management of any entity. <br />