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<br />SWORN STATEMENT PURSUANT TO Sl';C'flON 287.133(3)(0)
<br />F'LORIUA STA nJn~s.. ON PUBLIC ENTITY CRIM.F..S
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<br />TI-IlS FORNf ;\-HJST BE SIGNED AND S"VOR.J'i TO IN THE PRESENCE OF A NCrrARY PUBLlC OR OTHER
<br />OH:;lClAL AUfHORIZED TO ADMINISTER OATHS.
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<br />[, This sworn ~talemcnt iii submitted to _-=r h e... (~; +'t-.Qf__~,~~!'\ '-I -=.r ~:jk'; 13.2_~...~h
<br />by..J/..H \ <. I' a Pr (\a {; 0 ,y'2-~-Z \ e -z.. (Media Relatio!.1..~.-2~?~'!.J?:.__!:-LC)_,........._..,__..oo.oo_,oooo______oo___
<br />-.. -..... . I ~ ..' C' 0_ (" '- G ' r._:' /', "-
<br />for K \- ~ 1\.-' f~~,J -.. 0 3- : \ \ t 'r'1" ~~.':;., (l (H~ \ ) eJ\e. j:;'.. .L~J_.!'lCc.' .. \ n:) ~~~Y...l~.A1,
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<br />whose bus ine"s uddn:.ss is I ~S 0 l?.\.....QJ r.\, (~\..l 1- I~. e" 'R 0 c. (;~-''r..s~ ," ~~s: q 0'7
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<br />,p c, \ \'1") e +tv ~ ct \./ .."E-~:::-_ :1 .3 i. S -, _._........____
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<br />and (if applicable)' its Fedem; Employer Identification Number (FEIN)' i.~ ._ 2- 0- _p ~ \ ~ L- L 0 oo___oo_
<br />(IFIlle entity had no FEIN, include Lhe Social Security Number uflhe individunl signing L"is sworn statement:
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<br />2. I undcrst<tnd that a "public cntity crime" il$ defined in Paragraph 287 . I 33(1)(g), l::l.9rida Statutes. means II. violation of
<br />any state or fedentl kw by a person 'villi respect [.() aud directly related to the !I'lmsllction of business with any public
<br />entity or wi(h an agency or political subdivision of any olher state or of the United Sl:1tes. Including. but not limited roo
<br />nny bid or contract for goods <Jr services to be provided to any public entity or nn agency or political subdivision or till)'
<br />olher .state 01' of the Unitt'.d Slates and involving antitrust. fraud. Ulef!., bribery. collusion, racketeerIng, conspiOlcy. or
<br />materinl misrepresentation.
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<br />3. I understand that "conyicted" 01' "conviction" as defined in Paragraph 287.l33(1)(b). flQl'J9.l!: Sta~ me..\IIS11 finding
<br />of guilt or n conviction of n public entity clime" with or without an adjudication of guilt. in any federal or state tJilll
<br />court of record relating to charges brought by indictment or informlltiou after July I, 1989, as a result of a jury verdict.
<br />nonjufY trial, or entry of B plea of guilty or nolo contenders.
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<br />4. I understand that ail Uaftllintc" as defined ill Paragraph 287, J 33(1)(n), fLQ,rida Statutes, means:
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<br />a. A predecessor or successor or a person convicted of a public entity [:rime; or
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<br />b, An entity under the control of any olltural penon who is active ill themanagemcnt oflbe entity and who has been
<br />convicted of a public entity cOllie. The term "affiliate" includes those offiC(".rs, dirl'.ctors. ehccutives, partners,
<br />shareholders. employees, members, and agent" who lire active in the m::magement of an affiliate, The ownership
<br />by one person of shares constituting a controlling interest in unotherperson. or a pooling of equipment or income
<br />among persons when not for fair market value under an arm's length agreement. shall bea prima facie Cil8e thllt
<br />one person controls another person. A pilrson who knowingl)' entcrsinto a joint vel1ture with a person who has
<br />boon con~'icted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.
<br />S, J un(h~rstllnd that a "person" as defined in Paragraph 287 ,133(1)(e). }lorida Statutes, means allY natural person or entit)'
<br />organized under the laws of' any slatc or of the United Statl!.S with the legal power 10 enter jilto a binding contrnct and
<br />which bids 01' applies to bid on contracts for the provision of goods or services let by 11 public entity. or which
<br />otherwise transacts or applies to trrm~acl. llll.sincss with n public entity, The Icon "persoll" include..'i those officers,
<br />directors. cXl-'Cutives. partners. shnreholders, employees. members, /lnd agents who are acth'ein ma.!1.1gemcnl of any
<br />entit~, .llo, i ') "
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<br />.l:il~e.{:aj i~lM.._ ('O ~~'11." J)" --
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<br />-- SIGNA'll)RE OF AFFIAi"IT j t._J
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<br />Alicia Ana Gonzalez
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<br />(printed 01' Type{] Legal Name of Affiant)
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<br />Stnte of ~- .!.2oo[..:~~t~:.._,County of l'i\, c'm; ~'QaJ L
<br />Sworn to and subscribed before me this 1 q-tL day of.. (\') [.. \
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<br />__fiL~.~~..~ 1'I (, G b ~'\Z, tl l, '1.-.
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<br />S \A S t~ ,,(~ (2. \1'\ t: S '2 t( ( "S __oo.._....__."_
<br />Notary's Name Printed, Stamped or Typed
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<br />._...._..._. 2007 by
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<br />....~,.~ 'SUSANAO MESZAROS
<br />/!-W.. ' ':.~ MY COMM.'SSION # D064, 3933
<br />~"~' ""': EXPIRES February 26. 2011
<br />" Qrf"l.;,..\
<br />~'u~' k "'.... . N'r~..sIllt""'C'A! oof'I'
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<br />Notary Sertl:
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<br />Pel:~)nally Known:
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<br />or Produced ldentiticatioll _Ide.nLificaLion Produced
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<br />Page 80f9
<br />RFQ 07-03-0 I Engineering Srv!oi Bridge Revised (Addendum.])
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