HomeMy WebLinkAboutConflict of Interest 01.12.2021 Schroeder, JoshuaSTATE OF TEXAS
COUNTY OF WILLIAMSON
Meeting Type and Date Cal
Agenda Item No.
CONFLICT OF INTEREST AFFIDAVIT
Agenda Item Topic & eioL ( �C>, . ,I\ fi & n/ 1,/ C
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I am a member of the C ity or name of City board, committee or
commission) of the City of Georgetdwn, 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 defined 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
or have an ownership of 10% or more of the fair market value of the business entity.
I or a person related to me in the first or second degree 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 first 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.
C. "OFI '
For r sons other than those listed above, I have a conflict of int rest (P] ase specify, e.g. Sec. 2.24.170 or other reason)
"Upon filing of this affidavit with the recording secretary and/or the City Secretary, I affirm that I will abstain from all participation, discussion and voting
involving the matter identified in the above -referenced agenda item whatsoever. 1-7
Further, Affiant sayeth not."
Affiant's Signature:
Printed Name:
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 a �] 20k.
is L
Notary @ub is in and for the State of Texas
County of Williamson
THIS AFFIDAVIT SHALL BE KEPT WITH THE OFFICIAL MINUTES OF THIS MEETING. IF AFFIANT HAS CHECKED ANY OF THE
ITEMS UNDER SECTION "A" RELATING TO "SUBSTANTIAL INTEREST," A COPY OF THIS AFFIDAVIT MUST ALSO BE SENT TO
THE CITY SECRETARY FOR THE CITY OF GEORGETOWN.
Conflict of Interest Affidavit
Rev. 01 /2021
' A _ ROBYN LOUISE DENSMORE
My Notary ID # 125657056
E)phs April 15, 2022