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SWOllN STATEMENT PURSUANT TO SECTION 287.133(J)(a) FLOI~IDA STATUTES. ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN TilE PRESENCE OF A NOTARY PURI.IC OR OTIIER OI'F1CIAL AUTIIORIZED TO ADMINISTER OA TlfS, I. .1 his s\\om statement is ~uhlllilled to City of Sunny Isles Beach -- - - - -- by _Edwin Mojena, PE, Vice Preside~ _ _ _ _ _ for H, W, Lochner, Inc, -" ---- --- - --- \\hose bu~iness address is 440 Sawgrass Corporate Parkway, Suite 206 ------- Sunrise, F~rida 33325 - - - -- lInd (if applicahle) its Federal Lmplo)'er Identificlltion Number (FEI~) is 36-2338811 (" the entity had no FEI", include the Social Security Numher of the individual signing this swam ~tatell1e~ ., I understand that a "public entit) crime" as defined in Paragraph 287,1 33(1)(g). Florida Statutes, means a \ iolation of an) statc or federal la\\ by a person \\ ith respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States. including, but not limited to. any bid or contract for good~ or sen ices to be provided to an) public emit) or an agenc) or political subdivision of any other state or of the United States and involving antitrust. fraud. theft. bribery, collusion, racketeering, conspiracy, or material misrepresentation, 3. I understand that "convicted" or "conviction" as ddined in Paragraph 287,133(I)(b), Florida Statutes means a finding of guilt or a conviction of a public entit) crime. with or \\ ithout an adjudication uf guilt. in any federal or state trial court of record relating to charges brought b~ indictment or information after July I. 1989, as 11 result of II jury verdict. nonjury trial. or entry of a plea of guilt) or nolo contenders. 4, I understand that an "affiliate" as defined in Paragraph 287,133(1)(a). Florida Statutes, means: a, A predecessor or successor of a person convil:ted of a public entity crime; or b. An entit) under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity comc, The tenn "affiliatc" includes those officers, directors, executives, partners, shareholdcrs. employees, members. and agcnts who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person. or a pooling of equipment or income among pcrsons when not for fair market value under an ann's length agreement. shall be a prima facie case that one person controls another person, A person who kno\\ ingly enters into a joint venture with a person \\ ho has been coo\ icted of a public emit) crime in Florida during the preceding 36 months shall be considered an affiliate, 5, I understand that a "person" as defined in Paragraph 287,133(1)(e). Florida Statutes, means any natural person or entity organized under the laws of any state or of the l1nited States \\ ith the legal power to cnter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let h~ a public entit), or which othem ise transacts or applies to transact business with a public entity, The term "person" includes those officers, directors, executives. partners, shareholders. emplo) ees. members, and agents \\ ho arc active in management of an) entit) ,