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otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members and agents who are active in management of an entity. 8. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies) Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity, nor any affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989. . The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity, or an affiliate of the entity has been charged with, and convicted of, a public entity crime subsequent to July 1, 1989, and (Please indicate which additional statement applies) There has been a proceeding concerning the conviction before a hearing officer of the State Flo o rida, Division of Administrative Hearings. The final order entered by the hearing officer did not place the person or affiliate on the convicted vendor list.(Please attach a copy of the final order) The person or affiliate was placed on the convicted vendor list. There has been a su Sequent proceeding before a hearing officer of the State of Florida, Division of Administrative Heanngs. The final order entered by the hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order) The person or affiliate has not been placed on the convicted vendor list. (Please describe any action taken by, or pending with, the Department of General Services) Signature: Date: STATE OF County OF Personally appeared before me, the undersigned authority, who after first being sworn by me, affixed his/her signature in the space provided above on this day of 19 . Notary Public, State at large My Commission Expires: 32 . .. _ _. _ ....f...�, y .. ,. �. . ... . . .. . ... .�. ... ._.. __ �. •.e...� rye ,�..r�ay� p. .