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SWORN STATEMENT UNDER SECTION 287 . 133 (3 ) (a ) FLORIDA STATUTES ,
<br /> ON PUBLIC ENTITY CRIMES
<br /> (To be signed in the presence of a notary public or other officer authorized to administer oaths . )
<br /> STATE OF FLORIDA
<br /> COUNTY OF INDIAN RIVER
<br /> Before me , the undersigned authority, personally appeared LAWRENCE J . MYERS , who ,
<br /> being by me first duly sworn , made the following statement:
<br /> 1 . The business address of TREASURE COAST CONTRACTING , INC .
<br /> (name of Bidder or Contractor) is 6290 OLD IX E H P . O . BOX 650249 , °: '
<br /> VERO BEACH , FL 32965
<br /> 2 . My relationship to TREASURE COAST CONTRACTING , INC .
<br /> (name of Bidder or Contractor) is PRESIDENT
<br /> ( relationship , such as sole proprietor, partner, president, vice president) .
<br /> 3 . 1 understand that a public entity crime as defined in Section 287 . 133 of
<br /> Florida Statutes includes a violation of any state or federal law by a person with respect to and
<br /> directly related to the transaction of business with any public entity in Florida or with an agency
<br /> or political subdivision of any other state or with the United States , including , but not limited to ,
<br /> any Bid or Contract for goods or services to be provided to any public entity or such an agency
<br /> or political subdivision and involving antitrust , fraud , theft , bribery, collusion , racketeering ,
<br /> conspiracy, or material misrepresentation .
<br /> 4 . 1 understand that "convicted " or "conviction " is defined by the statute to
<br /> mean a finding of guilt or a conviction of a public entity crime , with or without an adjudication of
<br /> guilt , in any federal or state trial court of record relating to charges brought by indictment or
<br /> information after July 1 , 1989 , as a result of a jury verdict, nonjury trial , or entry of a plea of guilty
<br /> or nolo contendere .
<br /> 5 . 1 understand that "affiliate " is defined by the statute to mean ( 1 ) a
<br /> predecessor or successor of a person or a corporation convicted of a public entity crime , or (2 )
<br /> an entity under the control of any natural person who is active in the management of the entity
<br /> and who has been convicted of a public entity crime , or (3 ) those officers , directors , executives ,
<br /> partners , shareholders , employees , members , and agents who are active in the management of
<br /> an affiliate , or (4 ) a person or corporation who knowingly entered into a joint venture with a
<br /> person who has been convicted of a public entity crime in Florida during the preceding 36
<br /> months .
<br /> 6 . Neither the Bidder or Contractor nor any officer, director, executive ,
<br /> partner, shareholder, employee , member or agent who is active in the management of the
<br /> Bidder or Contractor nor any affiliate of the Bidder or Contractor has been convicted of a public
<br /> entity crime subsequent to July 1 , 1989 .
<br /> ( Draw a line through Paragraph 6 if Paragraph 7 below applies )
<br /> 00310 - 9
<br /> F :\Utilities\UTILITY - ENGINEERING\Projects - Assessment Projects\West Side Subdivision - UCP#2177\Bid docs\specs\00310 Bid
<br /> Form .doc
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