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<br />facie case that one person controls another person. A person who knowingly
<br />enters into a joint venture with a person who has been convicted of a public entity
<br />crime in Florida during the preceding 36 months shall be considered an affiliate.
<br />
<br />5. I understand that a "person" as defined in Section 287. 133(1)(e), Florida Statutes,
<br />means any natural person or entity organized under the laws of any state or of the
<br />United States with the legal power to enter into a binding contract and which bids or
<br />applies to bid on contracts for the provision of goods or services let by a public entity,
<br />or which otherwise transacts or applies to transact business with a public entity. The
<br />term "person" includes those officers, directors, executives, partners, shareholders,
<br />employees, members, and agents who are active in management of any entity.
<br />
<br />6. Based on information and belief, the statement which I have marked below is true
<br />in a relation to the entity submitting this sworn statement. (Please indicate which
<br />one (1) of the following three (3) statements is applicable.)
<br />
<br />. (1) 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, or any affiliate of the entity has been charged
<br />with and convicted of a public entity crime within the past 36 months.
<br />
<br />_(2) 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, or any affiliate of the entity has been charged
<br />with and convicted of a public entity crime within the past 36 months.
<br />
<br />_(3) 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, or agents who are active in management of the
<br />entity, or any affiliate of the entity has been charged with and convicted of a public
<br />entity crime within the past 36 months. However, there has been a subsequent
<br />proceeding before a Hearing Officers of the State of Florida, Division of Administrative
<br />Hearings and the Final Order by the Hearing Officer determined that it was not in the
<br />public interest to place the entity submitting this sworn statement on the convicted
<br />vendor list. (Attached is a copy of the final order.)
<br />
<br />I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE
<br />CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN
<br />PARAGRAPH 1 (ONE) ABOVE IS FOR THE PUBLIC ENTITY ONLY AND, THAT
<br />THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR
<br />IN WHICH IT IS FILED AND FOR THE PERIOD OF THE CONTRACT ENTERED
<br />INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNDERSTAND THAT I AM
<br />REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
<br />CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN
<br />SECTION 287.017, FLORIDA STATUTES FOR THE CATEGORY TWO OF ANY
<br />CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
<br />
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