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<br />
<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br />FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES
<br />
<br />THIS FORM MUST I3E SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />OFFICIAL AUTHORIZED TO ADMINISTER OATHS,
<br />
<br />l. This sworn statement is submitted to Ci ty of Sunny Isles Beach
<br />
<br />by
<br />
<br />Manuel Benitez
<br />
<br />fur BCC ENGINEERING,
<br />
<br />INC.
<br />7300 North Kendall Drive,
<br />Miami, Florida 33156
<br />
<br />Suite 660
<br />
<br />whose business address is
<br />
<br />65-0540100
<br />
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is
<br />(IF the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement:
<br />
<br />2. I understand 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, 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 />Illaterialmisrepresentation,
<br />
<br />3. I understand that "convicted" or "conviction" as defined in Paragraph 287,133(1)(0), Florida Statutes means a finding
<br />of guilt or a conviction of a pnblic entity crime, with or without an adjudication of guilt, in any federal or state trial
<br />court ofrecorcl relating to charges brought by indictment or information after July I, 1989, as a result ofajury verdict,
<br />nonjury trial, or entry of a plea of guilty or nolo contenders.
<br />
<br />4, I understand that an "affiliate" as defined in Paragraph 287. I 33(1)(a), Florida Statutes, means:
<br />
<br />a, A predecessor or successor of a person convicted of a public entity crime; or
<br />
<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 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 agrecment, 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. I 33(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 legnl power to enter into n binding contract and
<br />which bids or applies to bid on contracts for the provision of goods or services let by n public entity, or which
<br />otherwise transacts or applies to transact business with a public entity, The term "person" includes those officers,
<br />directors, executives, partners, shareholders, employees. members, and agents who are active in management of any
<br />entity.
<br />
<br />~- ~~~^I~~~7c,F ^Ift;~i-=>::---
<br />
<br />MANUEL BENITEZ
<br />
<br />(Printed or Typed Legal Name or Affiant)
<br />
<br />State of FloridaCounty of!1..i~mi-:-DQ.~e
<br />Sworn to and subscribed beforc me this _ 24 th._ day of __._.iU'...KII-'____________.__._..__, 2007 by
<br />
<br />Manuel Benitez
<br />
<br />Susan Alfonso /(:(:LQ.;... 0--
<br />Notary's Name Printed, Stampedor Typed [)
<br />
<br />Personally Known: X or Produced Identification
<br />
<br />. ~~ '~'"enr.- Nota-ry Public Slateof Florida
<br />f "A 'f, Susan Alfonso
<br />~ r:~ i My Commission DD661540
<br />.....::~ f'O~ Expires 04/10/29!L__
<br />
<br />Identification Produced
<br />
<br />Page 8 of9
<br />
<br />I?I;Q I"lg SITes FiJr Gal' !lr/i'oslmClIlre OJ2.I07.{)oc
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