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<br />
<br />SWORN STATEMENT PURSUANT TO SECTION 287. 133(3)(a)
<br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
<br />
<br />TI-IIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />OFFICIAL AUTHORIZED TO ADMINISTER OA THS.
<br />
<br />I. This sworn statement is submitted to City of Sunny Isles
<br />
<br />by Ed J. Palacio, PE
<br />
<br />for Bermcllo A iamil & Partncrs, Inc.
<br />
<br />whose business address is 2601 South Bayshore Drive, Suite 1000, Miami, Florida 33133
<br />
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 59- 1722486
<br />(IF the entity had no FEIN, include the Social Security Number of the individual signing this SW0111 statement:
<br />
<br />2. I understand that a "public entity crime" as defined in Paragraph 287. I 33(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, but not 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 />other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or
<br />material misrepresentation.
<br />
<br />3. I understand that "convicted" or "conviction" as defined in Paragraph 287. I 33(1)(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 I, 1989, as a result of a jury verdict,
<br />nonjury trial, or entTY of a plea of guilty or nolo contenders.
<br />
<br />4. I understand that an "affiliate" as defined in Paragraph 287,133(1)(a), Florida Statutes, means:
<br />
<br />a. A predecessor or successor ofa person convicted ofa public entity crime; or
<br />
<br />b, An entity under the contTol 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 term "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 />by one person of shares constituting a 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 />5. I understand that a "person" as defined in Paragraph 287.133(1)( e), Florida Statutes, means any natural person or entity
<br />organized under the laws of any state or of the United States with the legal power to enter into a binding contract and
<br />which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which
<br />otherwise transacts or applies to tTansact business with a public entity, The term "person" includes those officers,
<br />directors, executives, paliners, shareholders, employees, members, and agents who are active in management of any
<br />
<br />~
<br />~---
<br />SIGNA TURE OF AFFIANT
<br />
<br />Ed J. Palacio, PE
<br />(Printed or Typed Legal Name of Affiant)
<br />
<br />State of f k-\ \Jo County of \0,\1 j(\\\ -
<br />Sworn to s.c.J:i.l~~~.', ,..
<br />.j:;f:v:~;'~, , MAR~A Q COUNA
<br />~.: :"~ MY COMMISSION # 00628868
<br />"{'it'.. ~:f/ E)(PIRES March 21, 2010
<br />1,C1r~\\
<br />(407;'39~"01 S3 FlofloaNolaryServ,ce,com
<br />Notary's Name Printed, Stamped or Typed
<br />
<br />\ ):), \jc
<br />day of
<br />
<br />
<br />, 2007 by
<br />
<br />l
<br />
<br />Notary Seal:
<br />
<br />Personally Known: Yv
<br />
<br />or Produced Identification
<br />
<br />Identification Produced
<br />
<br />Forms. Doc
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