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market value under an arm's length agreement, shall be a prime facie case that one person
<br />controls another person. A person who knowingly enters into a joint venture with a person who
<br />has been convicted of a public entity crime in Florida during the preceding 36 months shall be
<br />considered an affiliate.
<br />11�. | understand that a "person" as defined in Para. 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
<br />enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or
<br />services let by a public entity, or which otherwise transacts or applies to transact business with a public
<br />entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
<br />employees, members, and agents who are active in management of any entity.
<br />11.6. Based on information and belief, the statement which |have marked below is true in relation to the entity
<br />submitting this sworn statement. (Indicate which statement app|iem.\
<br />°y
<br />Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners,
<br />shareholders, employees, membe agents who are active In the management of the entitx, nor any
<br />affiUateofthe mnUhvhas been charged vv�hand convicted ofapublic entity ur|rn$mubeaque/�'toJuly 1,
<br />1989.
<br />�
<br />The entity submitting this sworn statement, or one ormore ofits officers, d|naotmro, axmuutkmo, partnerm,
<br />shareholders, employees, mnennbene, or agents who are eotkm in the management of the ort|t& or an
<br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
<br />The entity submitting this sworn statement, or one or more ofits officers, directors, executives,
<br />shareholders, employees, members, or agents who,are active in the management of the entity, or an
<br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
<br />1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of
<br />Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the
<br />State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer
<br />determined that it was not in the public interest to place the entity submitting this sworn statement on the
<br />convicted vendor list. (Attach a copy of the final order.)
<br />| UNDERSTAND THAT THE SUBMISSION OfTHIS FORM TOTHE CONTRACTING OFFICER FOR THE
<br />PUBLIC ENTITY IDENTIFIED |NPARAGRAPH 11.1) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
<br />THAT THIS FORM ISVALID THROUGH DECEMBER 31 OF THE CALENDAR YEARiNWHICH [[|8FILED. |
<br />ALSO UNDERSTAND THAT |ANREQUIRED TOINFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO
<br />ACC)NTR/*CT IN EXCESS OF THE THRESHOLD AMOUNT SECTION 287.017, FLORIDA
<br />STATUTES, FOR CATEGORY TVNOQFANy`CHANGE |NTHE (FnZAT|(}NCONTAINED |NTHIS FORM.
<br />vice. Poe I
<br />Sworn to?nd subscribed before me this day of 20 tZ I by
<br />(AFFIX NOTARY STAMP HERE) a—
<br />Signatypp: Notary Public — State of Florida
<br />t or Type Commis �1`1`19OSE ANTONIO ALONSO
<br />commission # FF 083252
<br />ersonally Known� OR Produced Identification Expires February 22, 2018
<br />Type of Identification Produced
<br />10119983n[1O
<br />
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