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<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
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<br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY
<br />PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
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<br />I. This sworn statement is submitted to City of Sunny Isle Beach
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<br />by David Gierach, P.E., CGC
<br />fur CPH Enqineers, Inc.
<br />whose business address is 1992 SW 1st Street, Miami, Florida 33135
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<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 59 - 2 068806
<br />(IF the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement:
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<br />2. I understand that a "public entity crime" as defined in Paragraph 287. I 33(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 transaction of business with any public entity or with an agency or political
<br />subdivision of any other state or of 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 state or of the United States and involving antitrust, fraud, theft,
<br />bribery, collusion, racketeering, conspiracy, or material misrepresentation.
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<br />3. I understand that "convicted" or "conviction" as defined in Paragraph 287. I 33(1)(b), Florida
<br />Statutes means a finding of guilt or a conviction of a public entity crime, with or without an
<br />adjudication of guilt, in any federal or state trial court of record relating to charges brought by
<br />indictment or information after July I, 1989, as a result of a jury verdict, nonjury trial, or
<br />entry of a plea of guilty or nolo contenders.
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<br />4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means:
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<br />a. A predecessor or successor of a person convicted of a public entity crime; or
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<br />b. 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 come. The term "affiliate" includes
<br />those officers, directors, executives, paItners, 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 persons 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.
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<br />5. 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
<br />with the legal power to enter into a binding contract and which bids or applies to bid on
<br />contracts for the provision of goods or services let by a public entity, or which otherwise
<br />transacts or applies to transact business with a public entity. The term "person" includes
<br />those officers, directors, executives, partners, shareholders, employees, members, and
<br />agents who are active in management of any entity.
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