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8 . Based on information and belief, the statement which I have marked below is true in relation <br /> to, he <br /> the entity submitting this sworn statement . ( Please indicate which statement applies ) <br /> `� Neither the entity submitting this sworn statement , nor any officers , directors , executives , <br /> partners , shareholders , employees , members or agents who are active in management of the <br /> entity , nor any affiliate of the entity have been charged with and convicted of a public entity <br /> crime subsequent to July I , 1989 . <br /> The entity submitting this sworn statement , or one or more of the officers , directors , <br /> executives , partners , shareholders , employees , members or agents who are active in <br /> management of the entity , or an affiliate of the entity has been charged with , and convicted of, <br /> ' a public entity crime subsequent to July I , 1989 , and ( Please indicate which additional statement <br /> applies ) <br /> ' There has been a proceeding concerning the conviction before a hearing officer of the <br /> State of Florida , Division of Administrative Hearings . The final order entered by the hearing <br /> officer did not place the person or affiliate on the convicted vendor list . ( Please attach a copy of <br /> the final order) <br /> ' The person or affiliate was placed on the convicted vendor list . There has been a <br /> subsequent proceeding before a hearing officer of the State of Florida , Division of <br /> Administrative Hearings . The final order entered by the hearing officer determined that it was in <br /> the public interest to remove the person or affiliate from the convicted vendor list . ( Please <br /> attach a copy of the final order) <br /> ' The person or affiliate has not been placed on the convicted vendor list . ( Please <br /> describe any ac ion t en by , or pe ing ith , the Department of General Services ) <br /> c <br /> Signature : Date : <br /> STATE OF �- Q <br /> COUNTY OF ' n <br /> Personally appeared before me , the undersigned authority , R i CII kSh�l <br /> who after first being sworn by m , affixed his/her signature in the space provided above on this <br /> ►' CA day of , 20� <br /> ' ,`2 :1 :w'too, <br /> Alyso P. Comfort <br /> MY COMMISSION # CC909615 EXPIRES <br /> Notary ublic , State at large May ss, NINE <br /> ' %'iopf �� BONDED THRU TROY FAIN INSURANCE INC <br /> My Commission Expires : <br /> ' ' * END OF SECTION <br /> 00450 - 2 Public Entity Crimes Affidavit <br /> FAPublic Works\Capital ProjeclslOslo • 43rd Avenue\CONTRACT DOCUMENTS1Public Entity Crimes Affidavit. doc Rev. 05/01 <br />