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<br /> market value under an arm's length agreement, shall be a prime fade 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 /> 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 /> 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 /> X 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 /> 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 /> 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 /> 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 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I
<br /> ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO
<br /> A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
<br /> STATUTES,FOR CATEGORY TWO OF ANY,CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
<br /> By:
<br /> (Signature)
<br /> Maurizio L Bettoli
<br /> (Printed Name)
<br /> Director of Operarinns
<br /> (Title)
<br /> Sworn to and subscribed before me this COU day of ,20 by
<br /> 11-(4-0 '1 O t rri-6/I I _
<br /> (AFFIX NOTARY STAMP HERE) -
<br /> Signa :Notary Public-State of FI �filrlsllq�li
<br /> g/- 1/4� t Er14.A)
<br /> Print or Type Commissioned Nam me
<br /> Personally Known OR Produced Identification 'x r t. o a
<br /> Type of Identification Produced /V----"C-__Or"'`r 'ff=
<br /> 101993 3 of 7 ; .fisln��•
<br /> Ij ti )
<br />
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