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SWORN STATEMENT UNDER SECTION 287.133(3)(a) <br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES <br />THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER <br />OFFICE AUTHORIZED TO ADMINISTER OATHS. <br />1. This sworn statement is submitted with the Enterprises General Administration <br />Agreement for Fred Fox, Inc., and tle-Indian River County. <br />2. This sworn statement is submitted by Fred Fox Enterprises, Inc. whose business <br />address is 26 Spanish Street, St. Augustine, Florida 32084, and (if applicable) its <br />Federal Employer Identification Number (FEIN) is 59-2443697. <br />3. My name is Fred D. Fox, and my relationship to the entity named above is <br />President of the Corporation. <br />4. I understand that a "Public Entity Crime" as defined in Paragraph 287.133(1)(g), <br />Florida Statutes, means a violation of any state or federal law by a person with respect <br />to and directly related to the transactions of business with any public entity or with an <br />agency or political subdivision of any other state of with the United States, including, <br />but not limited to, any bid or contract for goods or services to be provided to any public <br />entity or an agency or political subdivision of any other stat or of the United States and <br />involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material <br />misrepresentation. <br />5. I understand that "convicted" or "conviction" as defined in Paragraph <br />287.133(1)(b), Florida Statutes., means a finding of guilt or a conviction of a public <br />entity crime, with or without adjudication of guilt, in any federal or state trial court of <br />record relating to charges brought by indictment or information after July 1, 1989, as a <br />result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contendere. <br />6. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), <br />Florida Statutes., means: <br />1. A predecessor or successor of a person convicted of a public entity crime; <br />or <br />2. An entity under the control of any natural person who is active in the <br />management of the entity and who has been convicted of a public entity <br />crime. The term "affiliate" includes those officers, directors, executives, <br />21 <br />16� <br />