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executives. partners, shareholders, employees, members and agents who are active in management <br />ofan entity. <br />8. Based on information and belief. the statement which I have marked below is true in relation to <br />the entity submitting this sworn statement. (Please indicate which statement applies) <br />-XL Neither the entity submitting this sworn statement, nor any officers, directors, executives, <br />Partners, shareholders, employees, members or agents who are active in management of the entity, <br />not any affiliate of the entity have been charged with and convicted of a public entity crime <br />subsequent to July 1, 1989. <br />The entity submitting this mom statement, or one or more of the officers, directors, <br />executives, partners, shareholders, employees, members or agents who are active in management <br />of the entity, or an affiliate of the entity has been charged with, and convicted of, a public entity <br />crime subsequent to July 1, 1989, and (Please indicate which additional statement applies) <br />_ There has been a proceeding concerning the conviction before a hearing officer of the State <br />of Florida, Division of Adminis ative Hearings. The final order entered by the hearing officer did <br />not place the person or affiliate on the convicted vendor list. (Please attach a copy of the final <br />order) <br />The person or affiliate was placed on the convicted vendor list. There has been a <br />subsequent proceeding before a hearing officer ofthe State of Florida, Division of Administrative <br />Hearings. The final order entered by the hearing officer determined that it was in the public <br />interest to remove the person or affiliate forth the convicted vendor list. (Please attach a copy of <br />the final order) <br />The person or affiliate has not been placed on the convicted vendor list. (Please describe <br />any action taken by, �or pending <br />with,, theDepartmentof General Services) <br />Signature �— <br />Date: 141 t,a <br />State of Florida <br />County of Indian River <br />Personally appeared before me, the undersigned authority, Robert R. Hanis who a <br />being swom my me, affixed his/her signature in the space Provided above on this �i ilter fm <br />er day <br />of U(NI'9Cr ,2000. <br />swn o.wsriw <br />ur rawuspar.." <br />tary <br />NoPublic, State at Large HnRS; <br />MY Commission Expires: 9-pl'OWI d.'h °°'°""'""Yfl01 <br />