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2003-012
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Last modified
9/2/2016 11:44:44 AM
Creation date
9/30/2015 6:15:15 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
01/21/2003
Control Number
2003-012
Agenda Item Number
7.F.
Entity Name
Fred Fox Enterprises, Inc.
Subject
Housing Revitalization Community Development Block Grant
Project Number
03DB-1A-10-40-01-H12
Archived Roll/Disk#
3160
Supplemental fields
SmeadsoftID
2797
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.ry <br /> 8. Based on information and belief,the statement which I have marked below is true in relation to the entity <br /> submitting this sworn statement. (Please indicate which statement applies.) <br /> XX 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, nor any <br /> affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July, 1, <br /> 1989. <br /> The entity submitting this sworn statement, or one or more of the officers, directors, executives, <br /> partners, shareholders, employees,members, or agents who are active in management of the entity, or an <br /> affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, <br /> 1989,AND (Please indicate which additional statement applies.) <br /> There has been a proceeding concerning the conviction before a hearing officer of the State of <br /> Florida,Division of Administrative Hearings. The final order entered by the hearing officer did not place <br /> the person or affiliate on the convicted vendor list. (Please attach a copy of the final order.) <br /> The person or affiliate was placed on the convicted vendor list. There has been a subsequent <br /> proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final <br /> order entered by the hearing officer determined that it was in the public interest to remove the person or <br /> affiliate from the convicted vendor list. (Please attach a copy of the final order.) <br /> The person or affiliate has not between placed on the convicted vendor list. (Please describe any <br /> action taken by or pending with the Department of General Services.) <br /> Fred D. Fox(Signature) <br /> Date: <br /> STATE OF FLORIDA <br /> COUNTY OF PUTNAM <br /> PERSONALLY APPEARED BEFORE ME,the undersigned authority,Fred D.Fox,who, after first <br /> being sworn by me, affixed his signature in the space provided above on this aUPday of 'De e e ro h e r , <br /> 2002. <br /> NOTARY PUBLIC <br /> M Commission Expires: �Wft <br /> Y P a4 CATHERINE E.TUCKER <br /> 11MY COMMISSION# DD 155976 <br /> "�o►a'4°� EXPIRES:October 8,2006 <br /> 1.8043-NOTARY FL N—y Semoe 8 gang,Inc. <br />
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