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2011-134B
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2011-134B
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Entry Properties
Last modified
2/10/2016 10:22:50 AM
Creation date
10/1/2015 2:40:31 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
06/14/2011
Control Number
2011-134B
Agenda Item Number
8.D.2
Entity Name
Unified Recovery Group, LLC
Subject
Disaster Debris Removal and Disposal
Secondary Contract
Bid Number
2011040
Supplemental fields
SmeadsoftID
9990
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SWORN STATEMENT PURSUANT TO SECTION 287 , 133 (3) (A ) <br /> FLORIDA STATUTES ON PUBLIC ENTITY CRIME <br /> THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER <br /> OFFICIAL AUTHORIZED TO ADMINISTER OATHS . <br /> 1 . This sworn statement is submitted to Indian River County, Florida <br /> By Joel K . Scales , Chief Financial Officer <br /> ( print this individual ' s name and title) <br /> for Unified Recovery Group , LLC <br /> ( print name of entity submitting statements) <br /> whose business address is 631 Main Street, Baton Rouge , Louisiana 70801 <br /> and if applicable whose Federal Employer Identification Number (FEIN ) is 20- 3453095 <br /> If the entity has no FEIN, include the Social Security Number of the individual signing this sworn Statement : <br /> 2 . I understand that a "public entity crime" as defined in paragraph 287 . 133 ( 1 )( a), Florida Statutes , mean <br /> a <br /> violation of any state or federal law by a person with respect to and directly related to the transactions of <br /> business with any public entity or with an agency or political subdivision of any other state or with the United <br /> States including , but not limited to any bid or contract for goods or services to be provided to any public <br /> entity or any agency or political subdivision of any other state or of the United States and involving antitrust, <br /> fraud, theft, bribery , collusion , racketeering, conspiracy , or material misrepresentation . <br /> 3 . I understand that " convicted " or "convection" as defined in Paragraph 287 . 133 ( 1 )(b ), Florida Statutes means <br /> a finding of guilt or a conviction of a public entity crime, with or without adjudication of guilt, in any federal <br /> or state trial court of record relating to charges brought by indictment or information after July 1 , 1989, as a <br /> result of a Jury verdict, nonjury trial , or entry of a plea of guilty or nolo contendere. <br /> 4 . I understand that an "affiliate" as defined in paragraph 287 . 133 ( l )( a) , Florida Statutes , means : <br /> I . A predecessor or successor of a person convicted of public entity crime ; or <br /> 2 . An entity under the control of any natural person who is active in the management of the entity and who <br /> has been convicted of a public entity crime . The term "affiliate" includes those officers, directors , executives , <br /> partners , shareholders, employees, members , and agents who are active in the management of an affiliate . <br /> The ownership by one person of shares constituting a controlling interest in another person, or a pooling of <br /> equipment or income among persons when not for fair market value under an arm ' s length agreement, shall <br /> be a prima facie case that one person controls another person . A person who knowingly enters into a joint <br /> venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 <br /> months shall be considered an affiliate . <br /> 5 . I understand that a "person " as defined in Paragraph 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 enter <br /> into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let <br /> by a public entity , or which otherwise transacts or applies to transact business with a public entity . The term <br /> "person" includes those officers, executives, partners , shareholders, employees , members , and agents who are <br /> active in management of an entity . <br /> 6 . Based on information and belief, the statement which I have marked below is true in a relation to the entity <br /> submitting this sworn statement. (Please indicate which statement applies) . <br /> 36 <br />
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