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<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(A).FLORIDA STATUTES. ON
<br />Public Entity Crimes Sworn Statement
<br />
<br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENSE OF A NOTARY PUBLIC OR
<br />OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br />I. This sworn statement is submitted to the City of Sunny Isles Beach
<br />by Salvatore J. Giorlando, President
<br />[Print individual's name and title]
<br />for MEP STRUCTURAL Engineering and Inspections, Inc.
<br />[Print name of submitting sworn statement]
<br />whose business address is3730 Coconut Creek Parkway, Suite 100 Coconut Creek, FL 33066
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 04-3631783
<br />If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
<br />statement:
<br />
<br />[Social Security Number]
<br />
<br />2. I understand that a "public entity crime" as defined in Paragraph Section 287.133 (I)(g), Florida Statutes,
<br />means a violation of any state or federal law by a person with respect to and directly related to the
<br />transaction of business with any public entity or with an agency or political subdivision of any other state
<br />or of the United States, including, but not limited to, any bid or contract for goods or services to be
<br />provided to any public entity or an agency or political subdivision of any other state or of the United
<br />States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material
<br />misrepresentation.
<br />
<br />3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133 (I )(b), Florida Statutes,
<br />means a finding of guilt or conviction of a public entity crime, with or without an adjudication of guilt, in
<br />any federal or state trial court ofrecord relating to charges brought by indictment or information after July
<br />I, 1989, as a result of a jury verdict, non jury 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 (l)(a), Florida Statutes, means:
<br />
<br />A predecessor or successor of a person convicted of a public entity crime; or
<br />
<br />An entity under the control of any natural person who is active in the management of the entity and who
<br />has been convicted of a public entity crime. The term "affiliate" includes those officers, directors,
<br />executives, partners, shareholders, employees, members, and agents who are active in the management of
<br />an affiliate. The ownership by one person of shares constituting a controlling interest in another person,
<br />or a pooling of equipment or income among persons when not for fair market value under an ann's length
<br />agreement, shall be a prima 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 crime in Florida during
<br />the preceding 36 months shall be considered an affiliate.
<br />
<br />5. I understand that a "person" as defined in Paragraph 287.133 (l)(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 />let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The
<br />tenn "person" includes those officers, directors, executives, partners, shareholders, employees, members,
<br />and agents who are active in the management of an entity.
<br />
<br />6. Based on information and belief, the statement, which I have marked below, is true in relation to the entity
<br />submitting this sworn statement. [Initial next to statement which applies.]
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