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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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directors, executives, partners, shareholders, employees, members, and agents who are active <br /> in management of an entity. <br /> 8 . Based on information and belief, the statement which I have marked below is true in relation <br /> to the entity submitting this sworn statement. (Please indicate which statement applies .) <br /> XX Neither the entity submitting this sworn statement, nor any officers, directors, <br /> executives, partners, shareholders, employees, members, or agents who are active in <br /> management of the entity, nor any affiliate of the entity have been charged with and <br /> convicted of a public entity crime subsequent to July, 1 , 1989 . <br /> The entity submitting this swom statement, or one or more of the officers, <br /> directors, executives, partners, shareholders, employees, members, or agents who are <br /> active in management of the entity, or an affiliate of the entity has been charged with and <br /> convicted of a public entity crime subsequent to July 1 , 1989, AND (Please indicate <br /> which additional statement applies .) <br /> There has been a proceeding concerning the conviction before a hearing officer <br /> of the State of Florida, Division of Administrative Hearings . The final order entered by <br /> the hearing officer did not place the person or affiliate on the convicted vendor list. <br /> (Please attach a copy of 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 <br /> was in the public interest to remove the person or affiliate from the convicted vendor list. <br /> (Please attach a copy of the final order. ) <br /> The person or affiliate has not between placed on the convicted vendor list. <br /> (Please describe any action taken by or pending with the Department of General <br /> Services . ) <br /> Fred D . Fox ( Signature) <br /> Date : <br /> STATE OF FLORIDA <br /> COUNTY OF PUTNAM <br /> PERSONALLY APPEARED BEFORE ME, the undersigned authority, Fred D . Fox, <br /> who, after first being sworn by me, affixed his signature in the space provided above on this <br /> ,day of a , 2005 . <br /> L 1 <br /> NOTARY PUBLIC <br /> My Commission Expires : +�`µr CATHERINE E. TUCKER <br /> 'A MY COMMISSION # DD 155978 <br /> ��OF �SPQ EXPIRES: October 8, 2008 <br /> ' -OM3NOTARY FL Notary Service 8 Balding, inc. <br />
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