HomeMy WebLinkAboutBargainer_Tim - P&Z 08.16.2016 COICouncil/ Board /Commission•
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Meeting Date:._ 0 ' • /A I
Agenda Item Number: �/JiqAjEep
STATE OF TEXAS
COUNTY OF WILLIAMSON CONFLICT OF INTEREST AFFIDAVIT
I, TIM f!?a -QMIM , reside at 10' Q �%�` . I am a member ofthe
j7jgU#jt_•in�L H/"Ifni riJWiM1�iL�fCity Council, City Board, Committee or Commission) ofthe City ofGeorgetown, and I
f hereby lee this affxt. vit and on my oath state the following:
'7, 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 of Georgetown Code ofOrdmanes, 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 of Ordinances)
and/or an "economic interest" (as defined in Sec. 2.20.020.E ofthe City ofGeorgetown Code ofOrdinances) in the matter that's
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 fav market value ofthe 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% ofrry4iis/her
gross income for the previous year.
I or a person related to me in the fast 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 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
r property that is more than mmirrml 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 fromwhom, within the past 12 months, the City officialor official's spouse, directly or
indirectly, has solicited, received and not rejected or accepted an officer ofemployment, or is engaged in negotiations
pertaining to business opportunities.
C. " her"
For seasons other [ha}tthq`e listed above, I have }conflict ofjpttprest (Qlease spgcify,e.gi Sec. 2.24.170 or other reason):
"Upon filing ofthis affidavit with the recording secretary and/or the City Secretary, I affirm that I will abstain from allparticipation,
discussion and voting involving the matter identified in the above -referenced agenda item whatsoever.
Further, Affiant sayeth not" 7j,
Printed Name: � 1 tr W
Affiants atuae-
Date: 3Z Iry
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 _ day of
Notary Public in and for the State of Texas
Countyof W illianson
THISAFFIDA VITSHALL BEKEPT WITHTHE OFFICIAL AIINUTES OF THIS MEETING. IFAFFIANT HAS CHECKEDANYOF THE ITEMS UNDER
�SECTION"A"RELATING TO "SUBSTANTIAL INTEREST, -A COPYOF THISANUDA VIT MUST ALSO BE SENT TO THE CITYSECRETARYFOR THE CITYOF
;' GEORGETOWN. Conflict of Interest Affidavit Revised 7.19.2011 El