HomeMy WebLinkAboutBrent_Bob - P&Z 11.04.2014 COICouncil / Board / Coipsio !
Meeting Date: // 'I /
Agenda Item Number: " E
STATE OF TEXAS
COUNTY OF WILLIAMSON CONFLICT OF INTEREST AFFIDAVIT
I, �/301 Qt?EJ/ , reside at 3119Z5_ let i 1 aW!iy / IFO . I am a member of the
(City Council, City Board, Committee or Co ission) of the City of Georgetown, and I
hereby make this affidavit and on my oath state the following:
"I, and/or a person or business entity whose interest is imputed to me under Chapter 171 of the Local Government Code and/or
Chapter 2.20 of the City of Georgetown Code of Ordinances, have a "substantial interest" in a business entity or in real property (as
defused by Chapter 171 of the Texas Local Government Code and Sec. 2.20.020.M of the City of Georgetown Code of Ordinances)
and/or an "economic interest" (as defined in Sec. 2.20.020.E of the City of Georgetown Code of Ordinances) in the matter that is
identified and described on the above -referenced agenda item.
"I 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 first or second degree have an ownership of 10% or more of the voting stock or shares of the
business entity
I or a person related to me in the first or second degree have an ownership of 10% or more of the fair market value of the
business entity or have an ownership of $15,000 or more of the fair market value of the business entity.
I or a person related to me in the fust or second degree received funds from the business entity in excess of 10% of my/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 me under Chapter 2.20 of the City of Georgetown Code of Ordinances 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 minimal 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 from whom, 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 of employment, or is engaged in negotiations
pertaining to business opportunities.
C. " her"
Fort
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"Upon filing of this affidavit with the recording secretary and/or the ity ere a at I wil
discussion and voting involving the matter identified in the above -referenced agenda item whatsoever.
Further, Affiant sayeth not."1'
Printed Name: /� ��/
Affsant's Sgnature:
Date: 04Z 3f 2
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 of his/her knowledge or belief.
SWORN TO AND SUBSCRIBED before me on this day of \ 1oNcmber l \\—
°:wIP�;,'�,, TAMMY R GLANVILLE 'Lsv`r� �"'
_� Notary Public, State of Texas Notary Public in a d the State of Texas
+, My Commission Expires County of Williamson
•.';; ui ls;`� April 24, 2016
THIS AFFlD /NUTESOFTHIS MEETIVG. IFAFFIANT HAS CHECKED ANYOF THE ITEMS UNDER
SECTION'A " RELA TING TO "SUBSTANTIAL INTEREST, "A COPY OF THIS AFFIDAVIT MUST ALSO BE SENT TO THE CITY SECRETARY FOR THE CITY OF
GFOROFTOWN CnnOicf of Jnierasl A>rdm,it Revised Z 19 201 /