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<br />6. Based on information and belief, the statement which I have marked below is true in relations to the entity
<br />submitting this sworn statement. (Indicate which statement applies.)
<br />
<br />. Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners,
<br />shareholders, employees, members, or agents who are active in the management of the entity, nor any
<br />affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July I,
<br />1989.
<br />
<br />D The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
<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.
<br />
<br />D The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
<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
<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 />
<br />I UNDERSTAND THAT THE SUBMISSIONOF THIS FORM TO THE CONTRACTING OFFICER FOR THE
<br />PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND
<br />THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS
<br />FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO
<br />ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUTN PROVIDED IN SECTION
<br />287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION
<br />CONTAINED IN THIS FORM
<br />
<br />~A. ~~~
<br />
<br />SIGNATURE OF AFFIANT
<br />
<br />Robert B. Deuser, Vice President
<br />(Printed or Typed Legal Name of Affiant)
<br />
<br />State of Florida
<br />
<br />Broward
<br />
<br />County of
<br />
<br />Sworn to and subscribed before me this 20th
<br />
<br />day of August
<br />
<br />, 2007 by
<br />
<br />Robert B. Deuser, Vice President
<br />
<br />Linda S. Scotece cJ ;/.
<br />Notary's Name Printe , Stamped or Typed
<br />
<br />
<br />Notary Seal:
<br />
<br />","If'f"
<br />.~-;,,;r.Y.M',
<br />!~&"';6',
<br />"'.. -.'"'
<br />~:. }<!:~
<br />"-1i:.....;t.l
<br />, 'Rrn~'\
<br />
<br />LINDA S. SCOTECE
<br />MY COMMISSION # 00 240707
<br />EXPIRES: December 13, 2007
<br />Bonded ThIU Notary Pttllic Underwrlters
<br />
<br />Personally Known: X
<br />Identification Produced
<br />
<br />Or Produced Identification
<br />
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