HomeMy WebLinkAboutBrent_Bob - P&Z 05.06.2014 COICouncil/ Board/ Com io :
Meeting Date: /
Agenda Item Number! I
STATE OF TEXAS
COUNTY OF WILLIAMSON CONFLICT
�OF INTEREST AFFIDAVIT
I, 30 al reside at 3/�oS/l h/f ems. I am a member ofthe
'09 I (City Council City Board, Committee or ConniL4wn) ofthe City ofGeorgetown, and I
hereby WhZ'e'MffHdM1aff on my oath state the following:
% and/or a person or business entity whose interest is imputed to me under Chapter 171 ofthe Local Government Code and/or
Chapter 2.20 ofthe City ofGeorgetown Code ofOrdinances, have a "substantial interest!' in a business entity or in real property (as
defined by Chapter 171 ofthe Texas Local Government Code and Sec. 2.20.020.M ofthe City of Georgetown Code ofOrdinances)
and/or an "economic interest" (as defined in Sec. 2.20.020.E ofthe City ofGeorgetown Code ofOrdinances) in the matter that is
identified and described on the above -referenced agenda item
'4 have a conflict of interest in the above -referenced agenda matter for the following reason(s): (check all that are applicable).
A. "Substantial Interest"
I or a person related to me in the fast or second degree have an ownership of 10% or more ofthe voting stock or shares ofthe
business entity
I or a person related to me in the fast or second degree have an ownership of 10% or more ofthe fair market value ofthe
business entity or have an ownership of$15,000 or more ofthe fair market value ofthe business entity.
I or a person related to me in the first or second degree received finds from the business entity in excess of 10% ofmy/his/her
gross income for the previous year.
I or a person related to me in the first or second degree have an equitable or legal ownership or interest in real property with a
fair market value of$2,500 or more.
B. "Economic Interest"
I or a person or entity whose interest is imputed to ire under Chapter 2.20 ofthe City of Georgetown Code ofOrdinances have
a legal or equitable interest in real or personal property or a fiduciary obligation to such property or contractual right in such
property that is more than minirml or insignificant and would be recognized by reasonable persons to have weight in deciding a
case or an issue. A City official may not take any official action that the official knows is likely to affect the substantial
economic interests of.
❑ the City official's family member or a business entity for which the city official serves as an officer, director, or in a
policy-making position,
❑ a person or business entity fromwhorn5 within the past 12 months, the City official or official's spouse, directly or
indirectly, has solicited, received and not rejected or accepted an officer ofem ployment, or is engaged in negotiations
pertaining to business opportunities.
C. "Other"
discussion and voting involving the matter identified in the above -referenced agenda item whatsoever.
Further, Affiant sayeth not"
Prbrted Name -
Affiants S"
Date:
BEFORE ME, the undersigned authority, on this day personally appeared the above-named person who on oath stated that the facts
hereinabove stated are true to the best ofhis/her knowledge or belief
SWORN TO AND SUBSCRIBED before me on this IL day of
Notary 'Public an r the State of Texas
County of W it iamson
THIS AFFIDAVIT SHALL BE KEPT WITHTHE• OFFICIAL MINUTES OF THIS MEETING. IFAFF/ANT HAS CHE•CKEDANYOFTHE ITERS UNDER
SECTION"A"RELATING TO "SUBSTANTIAL INTEREST,"A COPYOF TH/SAFFIDA VIT MUSTALSO BE SENT TO THE CITYSIiCRETARYFOR THE CITYOF
GEORGETOWN. Conflict ofGneresi Affidavi/ Revised 7.19.2011 ❑
,,eoi .-01,, TAMMY R GLANVILLE
?+ _ Notary Public, State of Texas
My Commission Expires
April 24, 2016