Addendum 04/24/1991RECEIVE ; �, 2 1 1991
RADDENDUM TO AGREEM EKF
WHERE, P4 :(�bntract was entered into between Betty Hibbs,
contractor and the Board of County Commissioners on January 30,
,1991, for trade show services and in an amount up to $2,250.00
r-
'.;
WHEREAS, it is necessary to increase that amount to $2,540.00
WITNESSETH:
This 4ddendum to Agreement is entered into this J2--
day of L , 1991, as follows:
Paragraph f of said contract is amended as follows:
2. Contractor attended trade shows as directed by the Monroe
County Tourist Development Council. The trade shows assigned,
included the following:
International Dive and Travel Show, October 11-14, 1990
(three show days, two travel days - $500.00)
National Tour Association, November 11-14, 1990
(two show days, two travel days - $300.00)
American Bus Association, December 2-5, 1990
(two show days, two travel days - $300.00)
Dive Equipment Manufacturers Association, February 7-10, 1991
(four show days, two travel days - $500.00)
Miami International Boat Show, February 14-20, 1990
(seven show days, two travel days - $800.00)
These expenditures total $2,400.00.
Paragraph 3 of said contract is amended as follows:
3. Payment: The Board of County Commissioners will pay up to
$2,540.00 as the amended amount to the contractor plus travel
expenses under limits of Florida Statute 112.061. The contractor
will be paid at a rate of $10.00 per hour for inter -office work (i.e.
trade show preparation and followup) and a rate of $100.00 per day
for trade show days and $50.00 per day for setup and travel days.
The trade show expenses total $1,400.00 and the expenses for inter-
office and followup total $140.00 for a contract total of $2,540.00.
In all other respects, the contract dated January 30, 1991,
remains in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this
Addendum to Agreement on the day and year written above.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY: _ — �
BY: __ _�✓`/�
--- -------------
BETTY HI BS
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
B Y : -- — /10
qi
\\ L IN�� ��.
11AY 2
SWORN STATL0 ENT UNDER SECTION 287.133(3)(a),
FLORIDA STATUTES ON PUBLIC ENTTIZ' CRIMES
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER
AUTHOR= TO ADMINISTER OATHS.
3.
'This sworn statement Is submitted with Bid, Proposal or Contract No.
for Trade .Show Assistant
This sworn statement Is submitted by Betty Hibbs
[name of entity submitting sworn statement)
whose business address is 7250 West Greens Road, Apt. 906, Houston, TX
77064
and
(if applicable) its Federal Employer Identification Number (FEIIN) Is
N/A
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
My name is Betty Hibbs
[please print name of Individual signing] and my relationship to the
entity named above is same
4. I understand that a 'public entity crime• as defined in Paragraph Z87133(1)(g), Mdda 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 entity or an 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.
S. I understand that'convicted• or *convictions as defined in Paragraph 287.133(1)(b)-Florlde Statu= means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of
Pill. Ina any federal or state trial court of record relating to charges brought by indictment or
or nolo contendere.
information after Jnly 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a ndl of guilty
6• I understand that an •affillate• as defined in Paragraph 287.133 1 a , Florida Statutes means:
L A predecessor or successor of a person convicted of a public entity crime: or
Z An entity under the control of any natural person who is active in the management of the
entity and Who i a: been convicted of a public entity crime. The term •affiliate' includes those
Officers, directors, executives, partners, shareholders, employees, members,
In the management of an affiliate. The Ownership and agents who are active
interest in another person, or a pooling of equipment one
amharCS sns htitu en otin odor fair
market value under an arms length agreement, shall be a prima fade vale tint one person can to
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 3f months shall be considered an
affiliate.
7• understand that a 'person' as defined in Paragraph 287.133(1)(e), Florida+ means an
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 provision
Of goods or services let by a public entity, or which otherwise transacts or applies to transact business
with a public entity. The term 'person' includes those officers, directors, executives, partners,
shareholders. emplovees, members, and agents who are active in management of an entim.
8• Based on information and belief, the statement which I have marked below
entity submitting this sworn statement. [Please Indicate which statemennappiicsrelation to the
•-•� ••-► v•,y... .w�GulGli►, 11U1 any 011lCCIb, UUCCluaa. CX=L1vks,
ArM,
shareholders, emplovees, members; or agenu 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 1, 1989.
The entity submitting this sworn statement, or. -ono of more of the officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in management of
the entity, or an atiiliata of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989, AM [Please Indicate which Additional statement applies.]
There has been a proceeding concerning the. conviction before a hearing* officer of
the State of Florida, Division of Administrative Bearings. The final order entered by the
hearing officer did not place the person or affiliata 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 in the public interest to removg the person or affiliate from the convicted vendor list•
[Please attach a ropy of the final order.]
_T 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.]
[signatu
Date: 9 /
STATE OF E-f�5
COUNTY OF ffffa
PERSON Y PEARED BEFORE ME, the undersigned authority,
L'L Mho, after first being sworn by Ine,.affixed his/her signature
[name of individual signin81 -
In the apace provided above on this
My commission expires:
ni•py+
a LOR::E.t RUFFIM
Notaryate of TexasMy Commis May 31.1993
Fo .. PUR 7068 (Rev. 11/89)