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a <br />40 <br />40 <br />7. I understand that a "Person" as defined in Paragraph 287.133(1)(e), Florida Statutes, <br />means any natural person or entity organized under the laws of any state of the United <br />States with the legal power to enter into a binding contract and which bids or applies to <br />bid on contracts for the provision of goods or services let by a public entity, or which <br />otherwise transacts or applies to transact business with a public entity. The term "person" <br />includes those officers, directors, executives, partners, shareholders, employees, members <br />and agents who are active in management of an entity. <br />8. Based on information and belief, the statement which I have marked below is true in <br />relation to the entity submitting this sworn statement. (Please indicate which statement <br />applies) <br />/ Neither the entity submitting this sworn statement, nor any officers, directors, <br />executives, partners, shareholders, employees, members or agents who are active in <br />management of the entity, nor any affiliate of the entity have been charged with and <br />convicted of a public entity crime subsequent to July 1, 1989. <br />The entity submitting this sworn statement, or one or more of the officers, <br />directors, executives, partners, shareholders, employees, members or agents who are <br />active in management of the entity, or an affiliate of the entity has been charged with, and <br />convicted of, a public entity crime subsequent to July 1, 1989, and (Please indicate which <br />additional statement applies) <br />There has been a proceeding concerning the conviction before a hearing officer of <br />the State of Florida, Division of Administrative Hearings. The final order entered by the <br />hearing officer did not place the person or affiliate on the convicted vendor list.(Please <br />attach a copy of the final order) <br />The person or affiliate was placed on the convicted vendor list. There has been a <br />subsequent proceeding before a hearing officer of the State of Florida, Division of <br />Administrative Hearings. The final order entered by the hearing officer determined that it <br />was in the public interest to remove the person or affiliate from the convicted vendor list. <br />(Please attach a copy of the final order) <br />The person or affiliate has not been placed on the convicted vendor list. (Please <br />describe any action taken by, or pending with, the Department of General Services) <br />Signature: <br />14& <br />Date / -2//01) <br />STATE OF <br />O WNEROF <br />Personally appeared before me, the undersigned <br />authority,_ 0 oc Nrrnjcu-z-- who after first being sworn by me, affixed z000 <br />his/her signature in the spacc provided above on this d ! —day of _) 7eu "-e,f ,19 <br />Notary Public, State at large / t— <br />My Commission Expires.. i og <br />OFFICIAL SEAL <br />PAULINE A CIOTOLA <br />NOTAFIV PUBLIC, STATE OF ILLINOIS <br />MY co MMlss!(1r�1 EX�'IILE8:03721AIA <br />^1 � a <br />