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2003-309
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2003-309
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Last modified
11/29/2016 2:22:58 PM
Creation date
9/30/2015 7:03:59 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
11/18/2003
Control Number
2003-309
Agenda Item Number
7.T.
Entity Name
Mid-State Mechanical of Vero Beach,Inc.
Subject
Chiller Replacement - Administration Building
Archived Roll/Disk#
3208
Supplemental fields
SmeadsoftID
3501
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SWORN STATEAWT UNDER SECTION 287 .I3 ' (N) , FLORIDA <br /> STATUTES ON PUBLIC ENTITY CRIMES <br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER <br /> OFFICER AUTHORIZED TO ADMINISTER OATHS . <br /> 1 . This sworn statement is submitted with Proposal No . 6095 <br /> 2 . This sworn statement is submitted by Robert F Ita I d <br /> whose business address is i R 9 c; :71 st strGet - Vero —Beaeh, 1 22967 and <br /> (if applicable) its Federal Identification No . (FEIN) is 59 . 1- 1327a7A If entity <br /> has no FEIN, include the Social Security Number of the individual signing this sworn <br /> statement : <br /> 3 . My name is N/A and my relationship to the entity <br /> named above is N/ A <br /> 4 . I understand that a "public entity crime" as defined in <br /> Paragraph 287 . I33 ( 1 )(g) , Florida Statutes, means a violation of any state or federal law by a person <br /> with respect to , and directly related to, the transaction of business with any public entity or with an <br /> agency or political subdivision of any other state or with the United States , including, but not limited <br /> to, any bid or contract for goods or services to be provided to any public entity or an agency <br /> or <br /> political subdivision of any state or of the United States and involving antitrust, fraud, theft, bribery, <br /> collusion, racketeering, conspiracy or material misrepresentations . <br /> • 5 . I understand that "convicted" or "conviction" as defined in Paragraph 287 . I33 ( 1 )(b) , Florida <br /> Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an <br /> adjudication of guilt, in any federal or state trial court of record relating to charges brought by <br /> indictment or information after July 1 , 1989, as a result of a jury verdict, non jury trail, or <br /> entry of a plea of guilty or nolo contendere . <br /> 6 I understand that an "affiliate" as defined in Paragraph 287 . I33 ( 1 ) (a) , Florida Statutes , means : <br /> a. A predecessor or successor of a person convicted of a public entity crime ; or <br /> b . An entity under control of any natural person who is active in the management of the <br /> entity and who has been convicted of a public entity crime . The term "affiliate" <br /> includes those officers, directors, executives , partners, shareholders, and employees , <br /> members, and agents who are active in the management of an affiliate . The Ownership <br /> by one person of shares constituting a controlling interest in another person, or a <br /> pooling of equipment or income among persons when not for fair market value under <br /> an arm ' s length agreement, shall be a prima facie case that one person controls another <br /> person. A person who knowingly enters into a joint venture with a person who has <br /> been convicted of a public entity crime in Florida during the preceding 36 months <br /> shall be considered an affiliate . <br /> • <br /> Page 30 of 48 <br />
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