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<br />
<br />SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
<br />FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
<br />
<br />THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC
<br />OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
<br />1. This sworn statement is submitted to City of Sunny Isles Beach, Florida
<br />by Keith & Associates, Inc.
<br />for RFQ No. 07-07-01, Professional Engineering Consultants
<br />
<br />whose business address is 301 East Atlantic Boulevard, Pompano Beach, Florida 33060
<br />
<br />and (if applicable) its Federal Employer Identification Number (FEIN) is 65-0806421
<br />(IF the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement:
<br />
<br />2. I understand that a "public entity crime" as defined in Paragraph 287.133(l)(g), Florida Statutes,
<br />means a violation of any state or federal law by a person with respect to and directly related to the
<br />transaction of business with any public entity or with an agency or political subdivision of any
<br />other state or of the United States, including, but not limited to, any bid or contract for goods or
<br />services to be provided to any public entity or an agency or political subdivision of any other state
<br />or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering,
<br />conspiracy, or material misrepresentation.
<br />
<br />3. 1 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 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 entry of a
<br />plea of guilty or nolo contenders.
<br />
<br />4. I understand that an "affiliate" as defined in Paragraph 287 .1 33(1)(a), Florida Statutes, means:
<br />
<br />a. A predecessor or successor of a person convicted of a public entity crime; or
<br />
<br />b. An entity Wlder the control of any natural person who is active in the management of the entity
<br />and who has been convicted of a public entity come, The term "affiliate" includes those
<br />officers, directors, executives, partners, shareholders, employees, members, and agents who are
<br />active in the management of an affiliate. The ownership by one person of shares constituting a
<br />controlling interest in another person, or a pooling of equipment or income among persons
<br />when not for fair market value tu1der an arm's length agreement, shall be a prima facie case that
<br />one person controls another person. A person who knowingly enters into a joint venture with a
<br />person who has been convicted of a public entity crime in Florida during the preceding 36
<br />months shall be considered an affiliate.
<br />
<br />5. I tu1derstand that a "person" as defined in Paragraph 287. 133 (l)(e), Florida Statutes, means any
<br />natural person or entity organized tu1der the laws of any state or of the United States with the
<br />legal power to enter into a binding contract and which bids or applies to bid on contracts for the
<br />provision of goods or services let by a public entity, or which otherwise transacts or applies to
<br />transact business with a public entity. The term "person" includes those officers, directors,
<br />executives, partners, shareholders, employees, members, and agents who are active in
<br />management of any entity,
<br />
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