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<br /> SWORN STATEMENT UNDER SECTION 287.133(3)(a)
<br /> FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
<br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICE
<br /> AUTHORIZED TO ADMINISTER OATHS.
<br /> 1. This sworn statement is submitted with the Enterprises General Administration Agreement for Fred Fox, Inc.,
<br /> and Indian River County.
<br /> 2. This sworn statement is submitted by Fred Fox Enterprises,Inc.whose business address is 330 St.Johns
<br /> Avenue,Palatka,Florida 32177, and(if applicable)its Federal Employer Identification Number(FEIN) is
<br /> 59-2443697.
<br /> 3. My name is Fred D. Fox,and my relationship to the entity named above is President of the Corporation.
<br /> 4. 1 understand that a"Public Entity Crime"as defined in Paragraph 287.133(1)(g), Florida Statutes,means a
<br /> violation of any state or federal law by a person with respect to and directly related to the transactions of business
<br /> with any public entity or with an agency or political subdivision of any other state of with the United States,
<br /> including,but not limited to, any bid or contract for goods or services to be provided to any public entity or an
<br /> agency or political subdivision of any other stat or of the United States and involving antitrust, fraud,theft,bribery,
<br /> collusion,racketeering, conspiracy, or material misrepresentation.
<br /> 5. 1 understand that"convicted" or"conviction" as defined in Paragraph 287.133(l)(b),Florida Statutes,means a finding
<br /> of guilt or a conviction of a public entity crime,with or without adjudication of guilt, in any federal or state trial court of
<br /> record relating to charges brought by indictment or information after July 1, 1989,as a result of a jury verdict,non jury
<br /> 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 Statutes,means:
<br /> 1. A predecessor or successor of a person convicted of a public entity crime; or
<br /> 2.An entity under the control of any natural person who is active in the management of the entity and who
<br /> has been convicted of a public entity crime. The term"affiliate"includes those officers, directors,
<br /> executives,partners, shareholders,employees,members, and agents who are active in the management of
<br /> an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or
<br /> a pooling of equipment or income among person when not for fair market value under an arm's length
<br /> agreement, shall be a prima facie case that one person controls another person. A person who knowingly
<br /> enters into a joint venture with a person who has been convicted of a public entity crime in Florida during
<br /> the preceding 36 months shall be considered an affiliate.
<br /> 7. 1 understand that a"person"as defined in Paragraph 287.133(1)(e),Florida Statutes,means any natural
<br /> person or entity organized under the laws of any state or of the United States with the legal power to enter
<br /> into a binding contract and which bids or applies to bid on contracts for the provision of goods or services
<br /> let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The
<br /> term"person" includes those officers, directors, executives,partners, shareholders, employees,members,
<br /> and agents who are active in management of an entity.
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