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person who has been convicted of a public entity en me 111 Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287.133(1)( e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of any entity. 6. Based on information and belief, the statement which I have marked below is true in a relation to the entity submitting this sworn statement. (Please indicate which one (I) of tit following three (3) statements is applicable.) ~ (1) Neither the entity submitting this sworn statement, nor any of its of1icers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or any af1iliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. _(2) The entity submitting this sworn statement, or one or more of its onicers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or any af1iliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. _(3) The entity submitting this swom statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who arc active in the management of the entity, or agents who are active in management of the entity, or any aniliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. However, there has been a subsequent proceeding before a Hearing Officers of the State of Florida, Division of Administrative Hearings and the Final Order by the Hearing Of1icer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attached is a copy of the final order.) UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR THE PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED AND FOR THE PERIOD OF THE CONTRACT ENTERED INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN f"..EXCESS F THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, . FLORID TATUTES FOR TI-IE CATEGORY TWO OF ANY CHANGE IN THE I .ORMA N CONTAINED IN TI-lIS FORM. \. :\;\~ ~ ~tw\2Q~\f' 2- ( rinted or Typed Legal Name of Af1iant)