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E. <br /> I <br /> 7 . There has been a conviction of a public entity crime Bidder or <br /> Contractor, or a r, director, executive, partner, shareholder, a yees , member or agent <br /> of the Bidder or Contra ho is active in the manageme a Bidder or Contractor or an <br /> affiliate of the Bidder or Contra A determinatio een made pursuant to Section <br /> 287 . 133 (3) by order of the Division o 1 ' rative Hearings that it is not in the public interest <br /> for the name of the convicted pers r affi i appear on the convicted vendor list. The <br /> name of the convicted pers r affiliate is . A copy of the order of the <br /> Division of Administr . Hearings is attached to this statem <br /> (Draw a through Paragraph 7 if Paragraph 6 above applies) <br /> 1 <br /> ason Chambers <br /> ,, Sworn to and subscribed before mein the state and county first me oned above on the gtiz <br /> day of April , 20 n3 <br /> (2LIJAt4q gtz4 (affix seal) <br /> Notary Public <br /> =NH;NN•t, i •• ••LAURIE CHAMBERS SHE FF i <br /> • 111N1! <br /> 01 PSA Commission # <br /> My C - 1 ex s 3/wzum • <br /> • Bonded through <br /> 47111410 Florida Notary ABM., M& <br /> b.NNNNONRN•••N•NNNNNNI.- - -- - -- ---- -- <br /> END OF SECTION <br /> 00310 - 10 <br /> E C:Wy DocumentsVrojectsV0262\Specifications100310 Bid Fortn.doc <br />