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<br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />. <br />I <br />I <br />I <br />I <br />I <br />i <br />i <br />I <br />I <br />I <br />I <br /> <br />6. Based on information and belief, the statement which I have marked below is true in a relation to <br />the entity submitting this sworn statement. (Please indicate which one (1) of the following three <br />(3) statements is applicable.) <br /> <br />~ (1) Neither the entity submitting this sworn statement, nor any of its officers, directors, <br />executives, partners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or any affiliate of the entity has been charged with and convicted of a public entity <br />crime within the past 36 months. <br /> <br />_(2) The entity submitting this sworn statement, or one or more of its officers, directors, <br />executives, partners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or any affiliate of the entity has been charged with and convicted of a public entity <br />crime within the past 36 months. <br /> <br />_(3) The entity submitting this sworn statement, or one or more of its officers, directors, <br />executives, partners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or agents who are active in management of the entity, or any affiliate of the entity has <br />been charged with and convicted of a public entity crime within the past 36 months. However, there <br />has been a subsequent proceeding before a Hearing Officers of the State of Florida, Division of <br />Administrative Hearings and the Final Order by the Hearing Officer determined that it was not in the <br />public interest to place the entity submitting this sworn statement on the convicted vendor list. <br />(Attached is a copy of the final order.) <br /> <br />I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING <br />OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR <br />THE PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 <br />OF THE CALENDAR YEAR IN WHICH IT IS FILED AND FOR THE PERIOD OF THE <br />CONTRACT ENTERED INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNDERSTAND <br />THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A <br />CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, <br />FL A STATUTES FOR THE CATEGORY TWO OF ANY CHANGE IN THE <br />IN ATI THIS FORM. <br /> <br /> <br />Robert E. Chisholm, FAIA <br />(Printed or Typed Legal Name of Affiant) <br /> <br />tate f Florida County of Miami-Dade <br />~to and subscribed before me this :' day of <br /> <br />~~~T e. Ct-tlSH L A/\ <br /> <br />t\\l (." C) <;.., <br /> <br />, 2007 by <br /> <br /> <br />Pe onally Known: X <br /> <br />or Produced Identification <br /> <br />Notary Seal: <br /> <br /> <br />~e~ Jorge E. Gonzalez <br />{l~~ COf!1mfssion # 00611954 <br />..q,~~.... ExpIres November 6 2010 <br />'1'11I 80ndld ...... ~ ' , <br />"VI _n - fnIu_, lilt 8CJO.38&. 701' <br /> <br />Identification Produced <br />