Korkat, Inc - Laserfiche WebLink

Home Browse Search

person who has geen convicted of a publi(; entity crime in Florida during the preceding36 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 organizedullder the laws of any state or of the United States with the legal po\ver to enter into a binding contract and which bids or applies to bid on contracts for the provision qf goods or services let by a public entity, or which otherwise transacts or applies to transact busineSs with a public entity. The term "person" inclucies those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of any entity. 6. Based on infomlation and belief, the statement which I have marked below is true in a relation to the entity submitting this swam statement. (Please indicate which one (1) of the following three (3) statements is applicable.) -X- (1) Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, paltners, shareholders, employees, members, or agents who are active in the management of the entity, or any affiliate of the entity has been charged with and convicted of a public entity crime witJlin the past 36 months. _(2) The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,shareholders, employees, members, or agents who are.active in the management of the entity, or any affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. _(3) The entity submitting this swomstatement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or agents who are active in management of the entity, or any affiliate 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 Officer of the State of Florida, Divisiol} of Administrative Hearings and the Final Order by the Hearing Officer determined that it was not in the public interest to place the entity submitting this swam statement on the convicted vendor list. (Attached is a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (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 FORTHE PERIOD OFTHE CONTRACT ENTERED INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNQERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR THE CATEGORY TWO OF ANY CHANGE IN THE INF.O O~ I'J::~~N CO A.INED IN THIS FORM. ~~n._ Shane Lanier SIGNATURE OF AFFI (Printed or Typed Legal Name of Affiant)i 17