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JAN-13 -03 '0:50AIA FROM -CITY OF SUNNY ISLES BEACH +3055483113 T -288 r'.10 /16 F -246
<br />swoRN STATEMENT PURSUANT TO SECTION 2V.133(3)(a)
<br />FLORIDA S'I'rw.TUTES. ON PII LIC EN'rITY CRIMES
<br />THIS FOW MUST BF SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br />1. This ,worn statement is submitted to The City of Sunny Isles Beach`
<br />by Robert L. Greene
<br />for Martin Fence _Co.
<br />- - - -
<br />whose business address is 862 13th Street
<br />Lake Park, FL 33403
<br />and (if applicable) its Federal Employer identification Number (FEM is 59- 1892263
<br />(1F the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement:
<br />2. 1 understund that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of
<br />any state or federal law by a person with respect to and directly related to the transaction of business with any public
<br />entity or with an agency or political subdivision of any other state or of the United States, including, bul nor limited to,
<br />any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any
<br />onccr state or of the United States and involving antiWAST, fraud, theft, bribery, collusion, racketeering, conspiracy, or
<br />material misrepresentation.
<br />3. 1 understand that "convicted" or "conviction" as defined in Paragraph 2$7.133(l)(b), Florida Statutes means a finding
<br />of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial
<br />court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict,
<br />nonjur, trial, or entry of a plea of guilty or nolo contenders.
<br />4, 1 understand that an "`affiliate" as defined in Paragraph 287.133(1)(a), Florida Stardtes, means:
<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 who has been
<br />convicted of a public entity come. The terra "affiliate" includes those officers, directors, executives, partners,
<br />shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership
<br />b} one person of shares constituting it controlling interest in another person, or a pooling of equipment or income
<br />among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that
<br />one person 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 considered an affiliate.
<br />I understand that a " erSon" as defined in Paragraph 287.133(l)(e), Florida Statutes, means any natural penon or entity
<br />arganized dund laws of any state or of the United States with the Iegal power to enter into a binding contract and
<br />which bid pplics bid on contracts for the provision of goods or services let by a public entity, or which
<br />cnherwis' KIS�r/,f�pplies to" t business with a public entity. The term "person" includes those officers,
<br />directa ,�ecp;}ve partners, sh a lders, employees, members, and agents who are active in management of any
<br />Robert L, Crepne
<br />SIGNATURE OF AFF NT (Primed or Typed Legal Name of Aitiant)
<br />Statr of Florida County of _Palm Beach
<br />Sworn to and subscribed before me this 23 _ day of January _ —v 200 „•.,• by
<br />Robert L. Greene
<br />Miser „le M. Sr hradpr Norm) Sea!-
<br />?~lorary's Name Printed, Stamped or Typed scorer
<br />Mischelle M
<br />- '�?' "= MY COMMi`S10N # DD091112 EXPIRES
<br />personally Known: _ X or Produced Identific 'on „; i-ebruoty 24, 2006 Mc
<br />_�- '`� • ?r BONDEDiHRU TROY
<br />FAIN"S
<br />1, entifcation Produced
<br />Page 9 of 10
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