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<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br />FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES
<br />
<br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br />
<br />I, Thisswornstatementissubmittedto City of Sunny Isles
<br />
<br />by Nasir M. Alam, P.E. - Principal In Charge
<br />
<br />fur Pistorino & Alam Consulting Engineers. Inc.
<br />
<br />whose business address is 7171 SW 62nd Avenue, 4th Floor
<br />South Miami, Florida 33143
<br />
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 59 - 2 6 8 6 5 3 2
<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(l)(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(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 I. 1989, as a result of a jury 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(l)(a), Florida Statutes, means:
<br />
<br />a. A predecessor or successor of a person convicted of a public entity crime; or
<br />
<br />5,
<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 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 "person" as defined in Paragraph 287 ,133(l)(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 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 />Lct'Z--_
<br />
<br />SIGNATURE OF AFFIANT
<br />
<br />Nasir M. Alam, P.B.
<br />(Printed or Typed Legal Name of Affiant)
<br />
<br />State of FloridaCountyof Dade
<br />Sworn to and subscribed before me this 23
<br />
<br />May
<br />
<br />, 20027by
<br />
<br />day of
<br />
<br />Nasir M. Alam
<br />
<br />
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<br />Notary's Name Printed, Stamped or~
<br />
<br />Personally Known:
<br />
<br />x
<br />
<br />or Produced Identification
<br />
<br />Identification Produced
<br />
<br />Page 6 of 7
<br />
<br />07-04-02 Gen Eng Srn Heritage Pk Garage Bid (Rfq)
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