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2003-118A.1
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2003-118A.1
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Entry Properties
Last modified
10/13/2016 4:51:24 PM
Creation date
9/30/2015 6:31:31 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
05/20/2003
Control Number
2003-118A.1
Agenda Item Number
7.F.
Entity Name
East Gifford Stormwater Improvements
Subject
Volume 1 Bidding Documents, contract forms, and conditions of contract
Project Number
9219
Bid Number
5063
Archived Roll/Disk#
3161
Supplemental fields
SmeadsoftID
3251
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8 . Based on information and belief, the statement which I have marked below is true in relation <br /> Ito th entity submitting this sworn statement. (Please indicate which statement applies ) . <br /> 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 <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 /> The entity submitting this swom statement, or one or more of the officers , directors , <br /> 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 1 , 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 /> mmmmmmm'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 /> Signa re : Date: 5m , 7 , 0 '3 <br /> STATE OF Irf or 16oQ <br /> COUNTY OF 1' o r fi t n <br /> Personally appeared before me , the undersigned authority, 1 0rr � <br /> who after first being swom by me ; affixed his/her signature in the space provided above on this <br /> 11 day of MAy , 20 03 . <br /> " w ANMINETTE <br /> rokool .32llc, sWa <br /> issior{6 <br /> (800-t:_ - 1 F7e�da tary « <br /> * *WWWWWWW <br /> END OF SECTION <br /> 00450 - Public Entity Crimes Affidavit <br /> 00450 - 2 <br /> F*iPW[c WorksWAothmlSwmfwater Pro}eds%Gfford Ea9C4rNtnx00 + ContractOdding a Contmd D=xnans0ddln9 a Cont-ad Dom ments=450 - PubBc Endty crimes SQ <br /> AflidaviLdoc Rev. 05MI <br />
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