Laserfiche WebLink
8 , Based on information and belief, the statement which I have marked below is true in relation <br /> to 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. Pof 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 action taken or, pending with , the Department of General Services ) <br /> Signature Date :* <br /> STATE OF L <br /> COUNTY OF T <br /> Personally appeared before me , the undersigned authority, J <br /> who after first being ^sworn by me , affixed his/her signature in the space Fac vided above on this <br /> day of ). � 1L1 rCh 9 20 o <br /> Notary Publi St to at large Z Z� C)5 <br /> My Commission Expires : OJAQ <br /> * * END OF SECTION <br /> 00450 - Public Entity crimes Affidavit <br /> 00450 - 2 <br /> FAPublic Works\Capital ProiectsWourth Street-Old Dixie-US I \CONTRACT DOCUMENTS\00450 - Public Entity Crimes Aflidavit.doc <br />