HomeMy WebLinkAboutexhibit14FLORIDA STAT[TrES, ON PUBLIC ENTITY CREMES
MIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICER AUTHORIZED TO ADMINISTER OATHS.
1. This sworn statement is submitted with Bid, Proposal or Contract No.
B3285
for City:`.Ha11 Commission Chambers Lighting, Sound & Interior Improvements
2. This sworn statement is submitted by McCartney Construction Company
[name of entity submitting sworn statement]
whose business address is 4800 SW 64th Avenue, Suite 109, Davie, FL 33314
and
(if applicable) its Federal Employer Identification Number (FEM) is 59-2283480
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement:
.)
3, My name is Sheldon McCartney and my relationship to the
[please print name of individual signing]
entity named above is President
4, I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a
violation of any state or federal law by a person with respect to and directly related to the transaction of
business with any public entity or with an agency or political subdivision of any other state or with the United
States, including, but not limited to, any bid or contract for goods or services to be provided to any public ennty
or any agency or political subdivision of any other state or of the United States and involving antitrust, fraud,
theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
5. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1Xb), Honda Statutes, means a
finding of guilt .or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal,
or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a
result of a jury verdict, non jury trial., or entry of a plea of guilty or nolo contendere.
6. I understand that an "affiliate" as defined in Paragraph 287.133(1Xa), Florida Statutes means:
1 A predecessor or successor of a person convicted of a public entity crime: or
?, An entity under the control of any natural person who is active in the management of the entity and who
has been convicted of a public entity crime. The term "affiliate" includes those officers, directors,
executives, parmers, shareholders, employees, members, and agents who are active in the management of
an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or
a pooling of equipment or income among persons when not for fair market value under an arm's length
agreement, shall be a prima facie case that one person controls another person. A person who knowingly
enters into a joint venture with a person who has been convicted of a public entity crime in Florida during
the preceding 36 months shall be considered an affiliate.
7. I understand that a "person" as defined in Paragraph 287.133(1Xe), Florida Statutes, means any natural person.
or entity organized under the laws of any state or of the United States with .the legal power to enter into a
binding contract and which bids or applies to bid on contracts for the provisions of goods or services let by a
public entity, or which otherwise transacts or applies to transacts business with a public entity. The term
who are active in management of an awry.
8. Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this swom.statement. (Please indicate which statement applies.)
x Neither the entity submitting this sworn statement, nar any officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the
entity have been charged with and convicted of a public entity crime subsequent to July I, I989.
The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of the entity
has been charged with and convicted of a public entity crime subsequent to July 1, 1989, AND [Please indicates
which additional statement applies.)
There has been a proceeding concerning the conviction before a hearing officer of the State of
Flonda, Division of Administrative Hearings. The final order entered by the bearing officer did not place
the person or affiliate on the convicted vendor List. [Please attach a copy of the final order.]
The person or affiliate was placed on the convicted vendor list. There has been a subsequent
proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final
order entered by the hearing officer determined that it was is the public interest to remove the person or
affiliate from the convicted vendor list. [Please attach a copy of the final order.]
The person or affiliate has not been placed on the convicted vendor list [Please describe any
action taken by or pending with the Department of General Services.]
.
[Signature]
Date: 8/1.3Z02
STATE OF Florida
COUNTY OF
Broward
PERSONALLY APPEARED BEFORE ME, the undersigned authonty,
Sheldon McCartney who, after first being sworn by me, affixed hislher signature
[narne of individual signing]
in the space provided above on this 13 day of AUGUST
My Commission expires:
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Form PUR 7068 (Rev. 6/97)
2002
NOTARY PUBLIC