2000-301 - Laserfiche WebLink

Home Browse Search

SWORN STATEMENT UNDER SECTION 287.133(3)(a) STATE OF FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES (To be signed in the QP presence of a notary public or other officer authorized to administer oaths.) Florida COUNTY OF ___ P_ol_k _______ _ Before me, the undersigned autho1ity, personally appeared who, being by me first duly swom, made the following statement: Jason T . Chambers, I. The business address of Tri-Sure Corporation (name ofBiddcr or ContTactor)is P . O. Box 653, Auburndale, Fl 33823 2. My relationship to Tri-Sure Corporation (name of Bidder or Contractor) is __ v_i _c _e _P_r_e_s_i_d_e_n_t ___________ _ (relationship, such a:s sole proprietor, partner, president, vice president). 3. I understand that a public entity crime as defined in Section 287 .133 of Florida Statutes includes 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 in Florida or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any Bid or Contract for goods o~ services to be provided to any public entity or such an agency or political subdivision and involving antitrust, fraud, theft, bribery, collu:;ion, racketeering, conspiracy, or material misrepresentation. 4. I understand that "convicted" or "conviction" is defined by the statute to mean 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, non jury trial, or entry of a plea of guilty or nolo contendere. 5. I understand that "affiliate" is defined by the statute to mean (1) a predec essor or successor of a person or a corporation convicted of a public e ntity crime, or (2) an entity under the control of any natural person who is active in the management of th e entity and who has bee n convicted of a public entity crime, or (3) those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the manage ment of an affiliate, or (4) a person or corporation who knowingly entered into a joint ve nture with a r erson who has been convicted ofa public e ntity c rime in Florida during the preceding 36 mo nths. 003 10 -9 I I I I I I I I I