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40 • STATEMENT OF PUBLIC ENTITY CRIMES This form is a swom statement under Section 287.133(3)(a), Florida Statutcs, on public entity crimes and must be signed in the presence of a notary public or other officer authorized to administer oaths, t 1. This sworn statement is subn-dtted with Rid Tiro. 2© =— for Wahasso Caust!Way_Park Improve s 2. This swum statement is submitted by William Glover, Inc. l (name of entity sbbmining sworn stawnentj whose business address is 296 NorthBabcock 5t., Meltaoume, Florida 32935 and applicable) its Federal Employer Identification Number (FEIN) is 59-2300274 . {If the entity t has no FEIN, include the Social Security Number of the individual signing this sworn I statement: } t 3. My name is William Glover (please print name of individual signing) +Presidentt _ and my relationship to the entity named above is 4. I understand that a "Public Entity Crime" as defined in Paragraph 287.133(l)(g), Florida t Slatutas, means a violation of any State or Federal law by a person with respect to and directly related to the transaction of business with any public entity or with any agency or political subdivision of any other State or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency s or political subdivision of any other state or of the United States and involving antitrust, i fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. i 5. I understand that "convicted" or "conviction" as defined in Paragraph 286.133(1)(b), Elo ida t Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any Federal or State trial court of'record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or i entry of a plea of guilty or nolo contendere. b. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a),EloridiStatutcs, means: a. A predecessor or succc,:snr of a Licrsori rolivicted of a public cmity ai lute; or, b. An entity under the control of a natural person who is active in the management of the entity and who has bcen convictcd of a public entity crime. The tcrm "affiliate" t includes those officers, directors, executives, partners, shareholders, employees, members; . and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another L person, ora pool+nz of t!quipnicnt of income .unung persons when not for fair market value under an arm's length agreement, shall bt: a prima facie case that one person controls ar.ctlict pcisun.