Laserfiche WebLink
term "person" includes those officers , directors, executives , partners, shareholders, and employees, <br /> members and agents who are active in management of an entity. <br /> 8 . Based on information and belief, the statement, which I have marked below, is true in relation to the <br /> entity submitting this sworn statement. (Please indicate which statement applies) <br /> Neither the entity submitting this sworn statement, nor any officers, directors , executives , partners, <br /> 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 <br /> July 1 , 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, <br /> or an affiliate of the entity has been charged with, and convicted of, a public entity <br /> crime <br /> subsequent to July 1 , 1989, and (Please indicated which additional statement applies) <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 . <br /> The final order entered by the hearing officer determined that it was in the public interest to remove <br /> the person or affiliate from the convicted vendor list. (Please attach a copy of the final order) <br /> Th s r affiliate has not been place on the convicted vendor list. (Please describe any action <br /> t en by, or p nding with, the Department of General Services) <br /> a <br /> Signature: Date : <br /> STATE OF <br /> COUNTY OF b ) QPJ <br /> Personally appeared before me , the undersigned authority , Nrt� 6 alle'r who after <br /> t being sworn by me, affixed his / her signature in the space provided above on this `L day of <br /> 0C), <br /> No Public, State ILI large . ryIOANNIS MRSIS <br /> i <br /> My ommission Expires : ' NO MY COMMISSION # DD 175094 <br /> oma° EXPIRES: December 30, 2006 <br /> � '� P,f, •d ' Bonded Thru Notary Pubk Underwriters <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 <br /> Page 22 of 38 <br />