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SAN.,'
<br /> „ , �( PUBLIC ENTITY CRIMES
<br /> V ) City of Sunny Isles Beach
<br /> 18070 Collin Avenue
<br /> ',Ca•I t O.'° Sunny Isles Beach.FL 33160
<br /> o ,,, Telephone:(305)947-0606 Fax(305)949-3113
<br /> SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br /> FLORIDA STATUTES,ON PUBLIC ENTITY CRIMES
<br /> PUBLIC ENTITY CRIMES
<br /> Pursuant to the provisions of paragraph(2)(a)of Section 287.133, Florida State Statutes-"A person or affiliate
<br /> who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a
<br /> Bid on a Contract to provide any goods or services to a public entity,may not submit a Bid on a Contract with a
<br /> public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of
<br /> real property to a public entity,may not be awarded to perform Work as a Contractor,supplier,Sub-Contractor,or
<br /> Consultant under a Contract with any public entity,and may not transact business with any public entity in excess
<br /> of the threshold amount Category Two of Sec.287.017,FS for thirty six months from the date of being placed on
<br /> the convicted vendor list".
<br /> THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br /> OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br /> 1. This sworn statement is submitted to City of Sunny Isles Beach
<br /> by Maurizio L Bettoli,Director of Operations
<br /> ipmtl ndnnduars name and Wei
<br /> for Bettoli Trading Corp.D/B/A Bettoli Vending
<br /> [prod name o4 entity w Wig sworn stammentI
<br /> whose business address is:
<br /> 6095 NW 167th street Ste D4,Miami,FL.33015
<br /> and(if applicable)its Federal Employer Identification number(FEIN)is 65-1057065
<br /> (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
<br /> statement .)
<br /> 2. I understand that a"public entity crime"as defined in Paragraph 287.133(1)(g),Florida Statutes,means a
<br /> violation of any state or federal law by a person with respect to and directly related to the transaction of
<br /> business with any public entity or with an agency or political subdivision of any other state or with the
<br /> United States,including,but not limited to,any Bid or Contract for goods or services to be provided to any
<br /> public entity or an agency or political subdivision of any other state of the United States and involving
<br /> antitrust,fraud,theft,bribery,collusion,racketeering,conspiracy,or material misrepresentation.
<br /> 3. I understand that"convicted"or"conviction"as defined in Para.287.133(1)(b),Florida Statutes,means a
<br /> finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any
<br /> federal or state trail court of record relating to charges brought by indictment or information after July 1,
<br /> 1989,as a result of a jury verdict,non-jury trial,or entry of a plea of guilty or nob contendere.
<br /> 4. I understand that an"affiliate"as defined in Para.287.133(1)(a),Florida Statutes,means:
<br /> a.) predecessor or successor of a person convicted of a public entity crime;or
<br /> b.) Any entity under the control of any natural person who is active in the management of the entity
<br /> and who has been convicted of a public entity crime. The term"affiliate"includes those officers,
<br /> directors,executors,partners,shareholders,employees,members,and agents who are active in
<br /> the management of an affiliate. The ownership by one person of shares constituting a controlling
<br /> interest in another person,or a pooling of equipment or income among persons when not for fair
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