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<br />transact business with a public entity. The term "persons" indudes those officers, directors, <br />executives, partners, shareholders1 employees1 members, and agents who are active in <br />management of any entity. . <br /> <br />11.6. Based on information and belief, the statement which I have marked below is true in relation to <br />the entity submitting this sworn statement (Indicate which statement applies.) <br /> <br />x <br /> <br />Neither the entity submitting this sworn statement, nor any of it's officers1 directors, executives, <br />partners, shareholders, employees1 members, or agents who are active in the management of <br />the entity, nor any affiliate of the entitY has been charged with and convicted of a public entity <br />. crime subsequent to July 11 1989. . <br /> <br />The entity submitting this sworn statement,. or one or more of its officers, directors1 executives1 <br />partners1 shareholders, employees, members, or agents who are active in the management of <br />the entityl or an affiliate 'of the entity has been charged with and convicted of a public entity <br />crime subsequent to July 11 1989. <br /> <br />The entity submitting this sworn statement1 or one or .more of itS officers, directors, executives, <br />partners, shareholders1 employees, members1 or agents who are active in the management of <br />the entity, or an affiliate of the entity has been charged with and convicted of a public entity. <br />crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a <br />Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order <br />entered by the Hearing Officer of the State of Florida, Division of Administrative Hearings and the <br />Final Order entered by the Hearing Officer determined that it was not in. the publiC interest to <br />place the entity submitting. this sworn statement on the convicted vendor list. (Attach a copy of <br />the fioc3Iorder.) . <br /> <br />I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE <br />PUBUC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE) ABOVE IS FOR THAT PUBUC ENlTfY ONLY <br />AND1 THAT THIS FORM IS VAliD .THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS <br />fILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO IN FORM THE PUBllC ENTITY PRIOR TO <br />ENTERING . INTO. A CONTRACT IN EXCESS OF. THE THRESHOLD AMOUNT. PROVIDED IN SECTION <br />287.017, FLORIDA STATIlTES, FOR. CATEGORY TWO OF A INFORMATION <br />CONTAINED IN THIS FORM. ) <br /> <br />-----,// <br /> <br />By: \... <br /> <br />(~jgnature) <br />HAMID FOULADI <br />(Printed Name) <br />PRESIDE~T <br />(Title) <br /> <br /> <br />~ <br /> <br />Sfh. to and J'bstribed before ;r ~is <br />. ;t:):1A ( --:FD {:J G. (1 <br /> <br />1 day of <br /> <br /> <br /> <br />....w..:w:.... MARIA LILIANA LATlEGUE <br />I[:f'~:~.~~ MY COMMISSION g DD 638227 <br />!~i'~'~'-i EXPIRES: June 9, 2011 P, 't T <br />~: ';~:9f.:!~~' Bonded Thru Notary Public Underwriters Iln or yp <br /> <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br /> <br />END OF SECTION <br /> <br />PAGE 61 OF 130 <br />BID No. 08-10-01 <br />