08/17/1994
HOUSEHOLD HAZARDOUS WASTE SERVICE AGREEMENT EXTENSION
Monroe County, a political sllbdivision of the State of
Florida (hereafter County), and Chemical Waste Management, Inc.,
a Delaware corporation with principal offices located at 3001
Butterfield Road, Oak Brook, IL 60521 (hereafter CWM), agree as
follows:
1. The service agreement between the County and CWM dated
September 29, 1993, is hereby extended for an additional one year
term commencing September 29, 1994. All the rates, terms and
conditions of the September 29, 1993, agreement will remain in
full force and effect dllring the term of this extension. This
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extension is authorized in CWM proposal no. 93PGB-0~ 4':lte~ul~
23, 1993, and incorporated into the September 29, 19~:agrMmedt;
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by reference.
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2. This extension agreement will take effect'., on t~ da8le
of the signature of the last party to sign.
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IN WITNESS WHEREOF, each party has caused this extension
agreement to be execllted by its duly authorized representative.
(SEAL)
Attest: DANNY L.KOLHAGE, Clerk
BY~~JI.J
eput er
Date August 17, 1994
By
COUNTY COMMISSIONERS
COUNTY, FLORIDA
(CORPORATE SEAL)
Attest:
NT , INC.
By
By
Title
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Date
coniiiwaste
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SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
County of Monroe, Florida
1.
This sworn st.tement is submitted to
by
for
Chemical Waste Management, Inc.
(print name of entity lubmittinglwum statement)
whose business address is
2700 N. W. 48th St.
~Pompano Beach, FL 33073
and (if applicable) its Federal Employer Identification Number (FEIN) is
36-2989152
(If the entity has no FEIN, include the Social Security Number of tbe individual signing this sworn
statement:
.)
2. I understand that. "public entity crime" a. defined in Paragraph 28^133(1)(g)~ Florida Statuta. .eaas a
violation of any state or Cederallaw by a person with respect to and directly related to tbe tra.actioD oC basiBell
with any public entity or with an agency or politica' subdivision of any other state or of the United States, including,
but not limited to, any bid or contract for goods or servi~es to be provided to any public entity or an agency or
politica. subdivision ~f any other st.te or of the United States and involving antitrust, Ir.ad, tlaeft, bribery,
conasion, racketeerint, conspiracy, or material misrepresentation.
3. I understand that"convicted" or "conviction" as defined in Paragraph 287.133(I)(b), Florida Statates, means a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in a.y federal or
state trial court of record relating to charges brought by indictment or information after July 1, 1919, as . result
of a jury verdict, Donjury trial, or entry of a plea of guilty or nolo contendere.
4. I understand tbat an "affiliate" as defined in Paragraph 287.133(I)(a), Florida Statutes, meaDS:
1. A predecessor or successor of a person convicted of. public entity crime; or
2. An entity under tbe control of any natural person who is Ktive in the maDagement of the entity aad who has
been convicted of. public entity crime. The term "amliate" includes thele offICers, directors, executives, partners,
sh.reholders, employees, members, and agents who are active in the m.nagement of an .ffiliate. The ownership
by one perSOD of shares constituting a controlling interest in another person, or pooling of equipment or income
among persons when not for fair inarket value under an arm's length agreement, shan be. prima facie case that
one person controls another person. A perso.D who knowingly enters into a joint venture with I person who hiS
been convicted of a public entity crime in Florida during the preceding 36 months shan be cODsidered an amliate.
S. I understand that a "person" as defined in Paragraph 287.t33(I)(e), Florida Statutes, means any natural person
or entity organized under the laws of any state or of the United States with the lega'power to enter into a binding
contract .ndwhich bids or applies to bid on contrKts for the provision of goods or services let by a public entity,
or which otherwise transacts or applies to transact business witb a public entity. The term "person" includes those
officers, directors, executives, partners, sharehelders, employees, members, and agentl who are active in
management of an entity.
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· 6. Rued OD iDformatioD aDd belief, the statemeDt which I have marked below is true iD relatioD to the eDtity
submittiDI this sworn statement. (Indicate which statement applies.]
~ Neither the eDtity submitting this sworn statemeDt, Dor aDY of its officers, directors, executives, partners,
sbareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of
the entity bas been charged with and convicted of a public entity crime subsequent to July 1, 1989.
-- The entity submitting this' sworn statement, nor any of its officers, directors, exectutives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor an affiliate of
the entity has been charged with and convicted of. public entity crime subsequent to July 1, 1989.
- The entity submitting this sworn statement, or ODe or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who. are active in the management of the entity, or an affiliate of
the entity has been charged with and convicted of. public entity crime subsequent to July 1, 1989 . However, there
has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearings and the Final Order entered by the Hearing Officer determined that it was Dot in the public interest to
place the entity submitting this sworn statement on the convicted vendor list. [attach a copy of the final order)
I UNDERSTAND THA TTHE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONL Y AND, THAT THIS
FORM' IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACf IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED INSECI10N287.017, FLORIDA STATUTES
FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONT D IN THIS RM.
SworD to ad subscribed before me this ) ~ day of
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Personally DOwn
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Notary Public - State of ~~~)
My CommissioD expires ~ U \ 'I l~ I ~
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(Printed typed or stamped
commissioned Dame of notary public)
OR Produced identificatioD
(Type of identification)
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LINOAE VODA
My eo..w~.~ CC2II3I2
E.....Jut.12.1817
Bonded by HAl
800~22.155a
Form PUR 7068 (Rev. 06111/92)