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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 /> 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 /> 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 /> 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 INF RMATION CONTAINED IN THIS FORM. <br /> Si nature <br /> ( 9 ) <br /> Mehrdad Mahmoudi <br /> (Printed Name) <br /> President <br /> (Title) <br /> Sworn to and subscribed before me this 10 day of December , 2018 , by <br /> Mehrdad Mahmoudi <br /> (AFFIX NOTARY v -0' <br /> ADI a <br /> 10.WO FDUI <br /> ol: lotid <br /> "0.'1 re( pu .Scale 1248 Signatuf�: <br /> 4•n• V PUB Y`•,.Notary -.Won <br /> blit ,FF_g7 <br /> _.'��'.? commis °lies Mar_14.202� <br /> 6' rc mm, xD <br /> ss'�i`gA` tM • <br /> i1lE O,F,,,, <br /> Pers: , , T OR Produced Identification <br />