Reso 2017-2724 - Laserfiche WebLink

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market value under an arms length agreerrierit; shall be a prime facie case that one Person' controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. . . 5. I understand that 'a''person" as defined in Para. 287:03(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 entit.y. The. term persons includes includet. those officer* directors; executives, partners, sharehOlders, emPloyeeS,MerriberS, and agents areettiVe in.rnana6emehibf anyentiti. 6. Based on information and belief, the statement which f:heve marked below istruein relation to the entity sWcirrrstaternent; (tilde:ate which statement applies.) Neither the entity submitting this sworn statement nor-any-of it officers directors executives.partners- . •.. . • • * • . Shareholders erriptoyeet, members or agents Who'are.:actiVe in the management of the entitY, nor any affiliate of the entity has beencharged with and convicted of a public entity crime subsequent to July _ - 1989. The entitY•e0brnittingthit'swornstatement, or one Or more of its officers, directOrt,eXecutiVeS, Pa-Ethers; shereholders, employees, meMbers, or agents who'are active in the management of the entity, or an affiliate of the entity hai'been,dharged ,and convicted'Of a public entity crime subsequent to July . 1989. . _ •The entity submitting this sworn,staternent or one or more of its officers directors executives partners, ihereholderS, eitiOlbyeet, MeMberSor agents who are active in the management of the entitY :Or an affiliate of the entity has been'charged withandconvicted of a public entity crime subsequent to July 1, • • 1989: Fic*thier. there has been a subsequent proceeding before.a Hearing Officer of the State of OlOrida,:Division of.Administrative Hearings the Final..Order'entered by the Hearing Officer of the • State of Florida Division of Administrative -Jeatiog and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this tworh-itatemanf on the convicted vendor liit.-,(AtfaCh4coPY Of thefinel Order,-) . . . I UNDERSTAND THAT THE:SUBMISSION, OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE):ABOVE,ISFOR THAT PUBLIC ENTITY pNLy AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OFTHE,CALENDAR'yEAR IN WHICH IT IS:FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC.ENTITY PRIOR TO ENTERING INTO CONTRACTA IN EXCESS OF 'THE THRESHOLD AMOUNT PROVIDED IN SECTION 287 017 FLORIDA STATUTES FOR OATEGORY TWOOF.ANY,-CHANGE IN THE INFORMATION CONTAINED IN THIS FORM - - • (Signator, • Afla icerrä • (Printed Name) Store Manager • (ritle) 'Sworn to and subscribed before uo- day of . September me this20 11 by "(AFFiX:NOTARYSTANIRHERE) Signature: Notary Public—State of Florida PrintOr Type Commissioned Nariie Personally Known OR Produced Identification Type of identification Produced 10/199e 3of7