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2005-039
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2005-039
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Last modified
7/7/2016 10:55:49 AM
Creation date
9/30/2015 7:45:01 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
02/01/2005
Control Number
2005-039
Agenda Item Number
7.R.
Entity Name
Fred Fox Enterprises
Subject
Home Again Disaster Relief General Administration Contract
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
3875
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SWORN STATEMENT UNDER SECTION 287. 133 (3)(a) <br /> FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES <br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR <br /> OTHER OFFICE AUTHORIZED TO ADMINISTER OATHS . <br /> 1 . This sworn statement is submitted with the Enterprises General Administration Agreement <br /> for Fred Fox, Inc . , and Indian River County. <br /> 2 . This sworn statement is submitted by Fred Fox Enterprises, Inc . whose business address is <br /> 330 St. Johns Avenue, Palatka, Florida 32177, and (if applicable) its Federal Employer <br /> Identification Number (FEIN) is 59-2443697 . <br /> 3 . My name is Fred D . Fox, and my relationship to the entity named above is President of the <br /> Corporation. <br /> 4 . I understand that a "Public Entity Crime " as defined in Paragraph 287 . 133 ( 1 )(g), Florida <br /> Statutes, means a violation of any state or federal law by a person with respect to and directly <br /> related to the transactions of business with any public entity or with an agency or political <br /> subdivision of any other state of with the United States, including, but not limited to, any bid or <br /> contract for goods or services to be provided to any public entity or an agency or political <br /> subdivision of any other stat or of the United States and involving antitrust, fraud, theft, bribery, <br /> collusion, racketeering, conspiracy, or material misrepresentation. <br /> 5 . I understand that "convicted " or " conviction " as defined in Paragraph 287 . 133 ( 1 )(b), Florida <br /> Statutes, means a finding of guilt or a conviction of a public entity crime, with or without adjudication of <br /> guilt, in any federal or state trial court of record relating to charges brought by indictment or information <br /> after July 1 , 1989 , as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo <br /> contendere. <br /> 6 . I understand that an " affiliate " as defined in Paragraph 287 . 133 ( 1 )(a), Florida Statutes, means : <br /> 1 . A predecessor or successor of a person convicted of a public entity crime ; or <br /> 2 .An entity under the 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 " includes <br /> those officers, directors, executives, partners, shareholders, employees, members, and <br /> agents who are active in the management of an affiliate . The ownership by one person of <br /> shares constituting a controlling interest in another person, or a pooling of equipment or <br /> income among person when not for fair market value under an arm's length agreement, <br /> shall be a prima facie case that one person controls another person . A person who <br /> knowingly enters into a joint venture with a person who has been convicted of a public <br /> entity crime in Florida during the preceding 36 months shall be considered an affiliate . <br /> 7 . I understand that a "person" as defined in Paragraph 287 . 133 ( 1 )(e), Florida Statutes, means <br /> any natural person or entity organized under the laws of any state or of the United States with <br /> the legal power to enter into a binding contract and which bids or applies to bid on contracts <br /> for the provision of goods or services let by a public entity, or which otherwise transacts or <br /> applies to transact business with a public entity. The term "person" includes those officers, <br /> 28 <br />
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