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<br />market value under an arm's length agreement, shall be a prime facie case that one person
<br />controls another person, A person who knowingly enters into a joint venture with a person who
<br />has been convicted of a public entity crime in Florida during the preceding 36 months shall be
<br />considered an affiliate.
<br />
<br />11.5. I understand that a "person" as defined in Para, 287,133(1)(e), Florida Statutes, means any natural
<br />person or entity organized under the laws of any state or of the United States with the legal power to
<br />enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or
<br />services let by a public entity, or which otherwise transacts or applies to transact business with a public
<br />entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
<br />employees, members, and agents who are active in management of any entity,
<br />
<br />11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity
<br />submitting this sworn statement (Indicate which statement applies,)
<br />
<br />Neither the entity submitting this sworn statement, nor any of it's 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 1,
<br />1989.
<br />
<br />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 />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 of the
<br />State of 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 SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
<br />PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
<br />THAT THIS FORM IS VALID THROUGH DECEMBER)1 OF THE CALENDAR YEAR IN WHICH IT IS FILED, I
<br />ALSO UNDERSTAND THAT I AM REQUIRED TO Fe M THE PUBLIC ENTITY PRIOR TO ENTERING INTO
<br />A CONTRACT IN EXCESS OF THE THRE LD MOUNT PROVIDED IN SECTION 287.017, FLORIDA
<br />STATUTES, FOR CATEGORY TWO OF A ,CH GE IN THE INF9RMATION NTAINED IN THIS FORM.
<br />
<br />By:
<br />
<br />(Si
<br />
<br />
<br />1.V ..' b
<br />(Pr(nled Na~ n / ~ a
<br />V Lee . \r'<PJl-to. . &tJCU t IJ r.?
<br />(Title) J "
<br />
<br />Swor\l to apd sUPscribed before me this I (p day of ti c.u-~ ' 20~, by
<br />H.exV\CUAdO ~ti l ~D
<br />
<br />-elrlfiJ&~
<br />
<br />
<br />,,,,\'..',.v "'~""
<br />tm" '" ~\ Notary Public. State 01 Florida
<br />. . ~ My Comm Expires Noy 2, 2014
<br />~ ':.J.e....~ CommisSIOn # H 39632
<br />'1. U"........
<br />· ,,~.:.,.." lIonded Thr lUttonal NotIlY AlIa.
<br />
<br />Signature: Notary P~bli9 - State of Florida
<br />~lnudiC< r::A(Q;r.QZO
<br />Prin or Type Commissioned Name
<br />
<br />Personally Known
<br />
<br />OR Produced Identification 'x'
<br />D \ F\ CZ ~1...(32052 1900
<br />
<br />Type of Identification Produced
<br />
<br />10/1998
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