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SWORN STATEMENT UNDER SECTION <br />287.133(3)(n), FLORIDA STATUTES ON PUBLIC ENTITY CRIMES <br />THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER <br />OFFICER. AUTHORIZED TO ADMINISTER OATHS. <br />I. This sworn statement is submitted with Proposal No.2025 Salary Survey <br />2. This sworn statement is submittpri <br />by QQQY_$ ASSOCIATES, INC. 305 Jack Drive, Cocoa Beach, FL <br />whose business address 32931 is <br />and (if applicable) <br />its Federal Identification No.(FEIN) is 59-150003] . If entity has no FEIN, include <br />the Social Security Number of the individual signing this sworn <br />statement: <br />3. My name is N. E. Pellegrino and my relationship to the entity <br />named above is enior Partner - <br />4. 1 understand that a "public entity crime" as defined in <br />Paragraph 287.133 (1)(g), Florida Statutes, means a violation of any state or federal law by <br />a person with respect to, and directly related to, the transaction of business with any public <br />entity or 'Kith an agency or political subdivision of any other state or with the United States, <br />including, but not limited to, any bid or contract for goods or services to be provided to any <br />public entity <br />or an agency or political subdivision of any other state or of the United States and <br />involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy or material <br />misrepresentations. <br />5. 1 understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), <br />Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or <br />without an adjudication of guilt. In any federal or state trial court of record relating to <br />charges brought by indictment or information after July I, 1989, as a result of a jury verdict, <br />non -jury trial, or entry of a plea of guilty or nolo contendere.. <br />6. 1 understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida <br />Statutes, means: <br />a. A predecessor or successor of a person convicted of a public entity crime; or <br />b. An entity unrt:er the control of any natural person who is active in tri trlandy�rt�errt <br />Uf the entity and who has been convicted of a public entity crime. the term "affiliate" <br />includes those officers, directors, executives, partners, shareholders, employees, <br />members and agents who are active In the management of an affiliate. the Ownership by <br />one person of shares constituting a controlling interest in another person, or a poolinwk of <br />equipment or income among persons when not for fair market value under an tam's length <br />agreement, shall be a prima facie case that one person controls another person. A person <br />who knowinaly ranters into a Joint venture with a person -who ha- been convicted of a <br />public entity crime in Florida during the preceding 36 months shall be considered an <br />affiliate. <br />10 <br />