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8 . Based on information and belief, the statement which I have marked below is true in relation <br /> to the entity submitting this swom statement. (Please indicate which statement applies ) <br /> ' Neither the entity submitting this sworn statement, nor any officers , directors , executives ,p rtners , shareholders , <br /> employees, members or agents who are active in management of the <br /> entity, nor any affiliate of the entity have been charged with and convicted of a public entity <br /> crime subsequent to July I , 1989 . <br /> � 1 <br /> The entity submitting this sworn statement, or one or more of the officers , directors , <br /> i executives , partners, shareholders, employees , members or agents who are active in <br /> management of the entity, or an affiliate of the entity has been charged with , and convicted of, <br /> a public entity crime subsequent to July I, 1989 , and (Please indicate which additional statement <br /> applies) <br /> There has been a proceeding concerning the conviction before a hearing officer of the <br /> State of Florida, Division of Administrative Hearings. The final order entered by the hearing <br /> officer did not place the person or affiliate on the convicted vendor list. (Please attach a copy of <br /> 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 was in <br /> the public interest to remove the person or affiliate from the convicted vendor list . ( Please <br /> 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 : Date : 2 Q <br /> STATE OFA <br /> COUNTY OF <br /> LU L A i 1v UC. <br /> Personally appeared before me , the undersigned authority, , <br /> who after first be' om by me , affixed his/her signature in the space provided above on this <br /> fn da , 20�. <br /> Not Publi at <br /> y Commission Expire . BRA MDI BOLLINGER <br /> Notary Public, state of Florida <br /> My comm . <br /> Co2005 <br /> mm , No .exres Aug , <br /> ID 951174 <br /> Bonded Thru service Insurance Company, Inc. <br /> * * END OF SECTION <br /> 0399-00450 - Public Entity crimes Affldavit.doc <br /> , . <br /> 00450 - 2 <br /> F.-%ngineerinoCapltal Projects\0399 North County Regional Park, Phase 1110399 Contract Docs\0399-00450 - Public Entlty Crimes AHldavit.doc Rev. 05/01 <br />