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<br />SWORN STATEMENT UNDER SECTION
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<br />287.133(3)(n), Florida STATUTES ON PUBLIC ENTITY CRIMES
<br />THISTORM MUST BE SIGNED�IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
<br />yOFFICER
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<br />-.. AUTHORIZED TO ADMINISTER OATHS.
<br />L 'Thi ssworn statement is submitted with.Bid, Proposal: for No 96080 for installation of Fiber
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<br />Optic Cable.
<br />2. This sworn,statementis submitted by;
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<br />whose business address,is
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<br />is < If entity has no °FEIN, include the Social Security Number of'the
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<br />individual! signing this sworn statement: m
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<br />3 My'name,is_ and my relationship to the entity named°
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<br />.above,W" -
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<br />471 understandthat a'"public entity crime" as defined in
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<br />; - `Paragraph 287,133 (1)(g), Florida Statutes, means a violation of any state or federal law by a
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<br />person with respect, to, and directly related to, the transaction of business with any public entity or '
<br />with an agency or political subdivision of any other state or with the United States, including, but
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<br />not :limited to, any bid or contract for goods or services to be provided to any public entity
<br />or an agency or political subdivision of_ any other state or of the United" States and involving
<br />antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy or material misrepresentations.
<br />r „f 5.a gI understand that" "convicted" or'"conviction" as defined in Paragraph 287.133(1)(b), Florida
<br />',i, ,Statutes, finding,of
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<br />' ,, means'a guilt or a conviction of a public entity crime, with or without an
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<br />- " adjudication of gguuilt, in any federal or state trial court of record relating to charges brought by
<br />indictment or information after July 1,1989; as a.result of a jury.verdict, nmjury trial, or entry of
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<br />a lea of ilt or nolo contendere.
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<br />6. 1 understand that an "affiliate"`as defined in Paragraph
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<br />287.M(1)(a), Florida Statutes, means:
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<br />a. A predecessor or successor of a person convicted of a public entity crime; or , _
<br />b. An the is in
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<br />entity under control of any natural person who active the management of the
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<br />entity and who has been convicted of a public entity crime• he term "affiliate" includes,
<br />those officers, directors, executives, partners, shareholders, employees, members and
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<br />agents who are active in the management of an affiliate. the Ownership by one _person of
<br />shares constituting -a controlling interest in another .person, or a pooling of equipment or
<br />income among persons when not for fair market value under an arm's lengt'hiagreement,
<br />shalltbe a prima facie case that one person
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<br />C. controls another person. A erson who k i&Mfi enters into a oint venture with a person
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<br />who has been convicted .of a public entity crime in Florida ",during the preceding 36 months
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<br />shall be considered: an affiliate.
<br />7. Punderstand thata "person" as defined in Paragraph
<br />287.133(l)(c), Florida Statutes, means any natural person or entity organized under the laws of any
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<br />state of.the-United States with the legal,power to enter into a binding contract and which bids or
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<br />applies to,bid on contracts for the provision of goods or services let'by a public entity, or which
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