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<br />. <br /> <br />. <br /> <br />. <br /> <br />6. Based on information and belief, the statement which I have marked below is true in a relation to <br />the entity submitting this swom statement. (Please indicate which one (\) of the following three <br />(3) statements is applicable.) <br /> <br />L (1) Neither the entity submitting this swom statement, nor any of its officers, directors, <br />executives, pal1ners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or any affiliate of the entity has been charged with and convicted of a public entity <br />crime within the past 36 months. <br /> <br />_(2) The entity submitting this swom statement, or one or more of its officers, directors, <br />executives, partners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or any affiliate of the entity has been charged with and convicted of a public entity <br />crime within the past 36 months. <br /> <br />_(3) The entity submitting this swom statement, or one or more of its officers, directors, <br />executives, pal1ners, shareholders, employees, members, or agents who are active in the management <br />of the entity, or agents who are active in management of the entity, or any affiliate of the entity has <br />been charged with and convicted of a public entity crime within the past 36 months. However, there <br />has been a subsequent proceeding before a Hearing Officers of the State of Florida, Division of <br />Administrative Hearings and the Final Order by the Hearing Officer determined that it was not in the <br />public interest to place the entity submitting this swom statement on the convicted vendor list. <br />(Attached is a copy of the final order.) <br /> <br />I UNDERSTAND THAT THE SUBMISSION OF THIS FORNI TO THE CONTRACTING <br />OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR <br />THE PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 <br />OF THE CALENDAR YEAR IN WHICH IT IS FILED AND FOR THE PERIOD OF THE <br />CONTRACT ENTERED INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNDERSTAND <br />THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A <br />CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, <br />FLORIDK"\STATUTES FOR THE CATEGORY TWO OF ANY CHANGE IN THE <br />INF MA -mON C T AINED IN THIS FORM. <br /> <br /> <br />Curtis Lee, P.G., Florida District Manager <br />(Printed or Typed Legal Name of Affiant) <br /> <br />State of FL County of O~I1~~ <br />Swom to and subscribed before me this 0> \ day of A )0.. v~ 1- <br /> <br />, 2007 by <br /> <br /> <br />Notary Seal: <br /> <br />~~Y'(f~ <br /> <br />.,.lM~ <br />~A.. ~ <br />'<Ofl\.\ii <br />(407) 398'{)153 <br /> <br />GAYLE M COSTANZA <br />MY COMMISSION # DD534628 <br />EXPIRES: Mar. 30, 2010 <br /> <br />Personally Known: <br /> <br />ROOda Notary Servica.com <br /> <br />Identitication Produced <br />