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Home My WebLink About04-19-2007 VC SP-M• • Present: ROLL CALL MINUTES OF THE SPECIAL SESSION VILLAGE COUNCIL OF NORTH PALM BEACH, FLORIDA APRIL 19, 2007 Dr. Edward M. Eissey, Mayor William Manuel, Vice Mayor David B. Norris, President Pro Tem Darryl Aubrey, Councilman T.R. Hernacki, P.E., Councilman Melissa Teal, CMC, Village Clerk Jimmy Knight, Public Safety Director Mayor Eissey called the meeting to order at 7:00 p.m. All members of Council were present. All members of staff were present, except the Village Attorney. PURPOSE OF THE SPECIAL SESSION The purpose of the Special Session was to interview applicants and make appointments to various Village Boards. The following persons were present for interviews by the Village Council: Amy Dean Christina Ivaldi Tom Magill Emery Newell Robert Gebbia Stephanie Waterman Susan Becker Eric Hoecker Christopher Ryder Glenn Brown Denise Whiteford Rosemary Truesdell Jon Begin Ted Meehan Harry Krivit Donald Cassady Patty Sullivan Susan Ryan Ira Brichta Cory Cross Susan Marks Jan Vandersluis Jay Carron Ken Wright Peter Carvajal AUDIT COMMITTEE By written ballot, a copy of which is attached to the copy of record, the Council appointed Amy Dean, Robert Gebbia, Christina Ivaldi, Tom Magill, Emery Newell, and David Talley to the Audit Committee. Thereafter, the names of those appointed were entered into Resolution 2007-51. CODE ENFORCEMENT BOARD Mayor Eissey noted a vacant position (term expiring 4/30/09) on the Code Enforcement Board due to the resignation of Ed Nessenthaler. By written ballot, a copy of which is attached to the copy of record, the Council appointed Glenn Brown, Eric Hoecker, Bill Norton, and Christopher Ryder to the Code Enforcement Board. Thereafter, the names of those appointed were entered into Resolution 2007-51. MINUTES OF VILLAGE COUNCIL SPECIAL SESSION HELD APRIL 19, 2007 • • • CONSTRUCTION BOARD OF ADJUSTMENT & APPEALS Mayor Eissey noted that Thomas Eissey, an incumbent member seeking reappointment, is his brother, therefore he will refrain from voting on Thomas Eissey's appointment. The position of HVAC contractor remains vacant at this time, due to the lack of qualified applicants. President Pro Tem Norris moved to reappoint the incumbent members. Vice Mayor Manuel seconded the motion, which passed with President Pro Tem Norris, Vice Mayor Manuel, Councilman Aubrey, and Councilman Hernacki voting aye. Thereafter, the names of Thomas Eissey, Frank Hollub, Ronald Schwab, Harry Ackerman, and Charles Giacomelli were entered into Resolution 2007-51. COUNTRY CLUB ADVISORY BOARD By written ballot, a copy of which is attached to the copy of record, the Council appointed John Archetti, Sandy Finck, and Rosemary Truesdell to the Country Club Advisory Board. Thereafter, the names ofthose appointed were entered into Resolution 2007-51. LIBRARY ADVISORY BOARD By written ballot, a copy of which is attached to the copy of record, the Council appointed Patty Sullivan and Susan Ryan to the Library Advisory Board. Thereafter, the names of those appointed were entered into Resolution 2007-51. PLANNING COMMISSION President Pro Tem Norris moved to reappoint the incumbent members in their present positions. Councilman Aubrey seconded the motion, and all present voted aye. Thereafter, the names of Ira Brichta, Cory Cross, Todd Engle, Kris Garrison, and Susan Marks were entered into Resolution 2007-51. POLICE & FIRE PENSION BOARD Councilman Hernacki moved to reappoint Robert DiGloria. Councilman Aubrey seconded the motion, which passed unanimously. Thereafter, the name of Robert DiGloria was entered into Resolution 2007-51. RECREATION ADVISORY BOARD By written ballot, a copy of which is attached to the coy of record, the Council appointed Paul Beach, Brian Mahoney, Mark Finney, and Carolyn Stone to the Recreation Advisory Board. Thereafter, the names ofthose appointed were entered into Resolution 2007-51. VILLAGE HISTORIAN Councilman Aubrey noted his relationship to current Village Historian, Joan Aubrey, therefore he will not be voting on this appointment. Vice Mayor Manuel moved to reappoint Joan Aubrey as Village Historian. President Pro Tem Norris seconded the motion, and Vice Mayor Manuel, President Pro Tem Norris, Councilman Hernacki, and Mayor Eissey voted aye. Thereafter, the name of Joan Aubrey was entered into Resolution 2007-51. 2 MINUTES OF VILLAGE COUNCIL SPECIAL SESSION HELD APRIL 19, 2007 • • WATERWAYS BOARD President Pro Tem Norris moved to appoint Scott Hicks and Ken Wright as regular members, Jay Carron as first alternate, and Denise Whiteford as second alternate. Councilman Aubrey seconded the motion, which passed unanimously. ZONING BOARD OF ADJUSTMENT Mayor Eissey reported that Norman Bott has moved out of town. President Pro Tem Norris moved to appoint Peter Carvajal as regular member, Ted Bukowski as first alternate, and Glenn Brown as second alternate. Councilman Aubrey seconded the motion, and all present voted aye. Brief discussion took place concerning the Council giving direction to the Boards so that they know what the Council expects from them. Discussion ensued on having someone attend the first meetings of the Board to give instruction and guidance on procedures, and on having a Workshop Session with Board Chairmen. RESOLUTION 2007-51 ADOPTED — APPOINTING MEMBERS TO VILLAGE BOARDS President Pro Tem Norris moved that Resolution 2007-51 entitled A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF NORTH PALM BEACH, FLORIDA, APPOINTING MEMBERS TO THE AUDIT COMMITTEE, CODE ENFORCEMENT BOARD, CONSTRUCTION BOARD OF ADJUSTMENT AND APPEALS, COUNTRY CLUB ADVISORY BOARD, LIBRARY ADVISORY BOARD, PLANNING COMMISSION, RECREATION ADVISORY BOARD, WATERWAYS BOARD, ZONING BOARD OF ADJUSTMENT, AND VILLAGE HISTORIAN; AND PROVIDING FOR AN EFFECTIVE DATE be adopted. Councilman Hernacki seconded the motion, which passed unanimously. ADJOURNMENT With no further business to come before the Council, the meeting adjourned at 8:45 p.m. /—(',d7 772� Melissa Teal, CMC, Village Clerk' 3 • • CLERK'S TALLY SHEET Audit Committee April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Becker, Susan Dean, Amy (I) Gebbia, Robert Ivaidi, Christina (I) Magill, Tom (I) Newell, Emery (I) Talley, David (I) a/-sic-t/WW�S 7H0, (Signature) Round 1 Round 2 Round 3 • BALLOT AUDIT COMMITTEE April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Round 1 Becker, Susan A Li - Dean, Amy (I) Gebbia, Robert Ivaldi, Christina (I) Magill, Tom (I) ,2rc, Newell, Emery (I) A I+ Talley, David (I) Waterman, Stephanie Round 2 Round 3 • • • BALLOT AUDIT COMMITTEE April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Round 1 Becker, Susan Dean, Amy (I) Z Gebbia, Robert Ivaldi, Christina (I) 11 Magill, Tom (I) 1 Newell, Emery (I) XI- i Talley, David (I) 3 Waterman, Stephanie At7 Z (Signature) Round 2 Round 3 • • • BALLOT AUDIT COMMITTEE April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Becker, Susan Dean, Amy (I) Gebbia, Robert Ivaldi, Christina (I) Magill, Tom (I) Newell, Emery (I) Talley, David (I) Waterman, Stephanie Round 1 Round 2 Round 3 • • • BAL LOT AUDIT COMMITTEE April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Becker, Susan Dean, Amy (I) Gebbia, Robert Ivaidi, Christina (I) Magill, Tom (I) Newell, Emery (I) Talley, David (I) Waterman, Stephanie (Signature) Round 1 Round 2 Round 3 • • • BALLOT AUDIT COMMITTEE April 19, 2007 Vacancies: 6 total (4 Regular and 2 Alternate) (I) = Incumbent Becker, Susan Dean, Amy (I) Gebbia, Robert Ivaldi, Christina (I) Magill, Tom (I) Newell, Emery (I) Talley, David (I) Waterman, Stephanie Leif-ft r L (Signatu`re) Round 1 ,-v led— v V Round 2 Round 3 • • • CLERK'S TALLY SHEET COUNTRY CLUB ADVISORY BOARD April 19, 2007 Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Round 1 Archetti, John (I) 0/ Becker, Susan Begin, Jon Cassady, Donald Finck, Sandy (I) all Krivit, Harry if Meehan, Ted 1 Truesdell, Rosemary (I) 1' 1 1 Whiteford, Denise (Signature) Round 2 Round 3 • • • BALLOT COUNTRY CLUB ADVISORY BOARD April 19, 2007 Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Round 1 Archetti, John (I) 1" Becker, Susan Begin, Jon Cassady, Donald Finck, Sandy (I) V / Krivit, Harry Meehan, Ted Truesdell, Rosemary (I) Whiteford, Denise (Signature) Round 2 Round 3 • • • BALLOT COUNTRY CLUB ADVISORY BOARD April 19, 2007 Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Archetti, John (I) Becker, Susan Begin, Jon Cassady, Donald Finck, Sandy (1) - Krivit, Harry — Meehan, Ted — Truesdell, Rosemary (I) Whiteford, Denise Round 1 y Round 2 Round 3 ,/ / • • • BAL LOT COUNTRY CLUB ADVISORY BOARD April 19, 2007 Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Arched, John (I) T Becker, Susan Begin, Jon Cassady, Donald Finck, Spdy (I) Krivit, Harry Meehan, Ted Truesdell, Rosemary (I) Whiteford, Denise (Signature) Round 1 Y Round 2 Round 3 • • • BALLOT COUNTRY CLUB ADVISORY BOARD April 19, 2007 • Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Archetti, John (I) Becker, Susan Begin, Jon Cassady, Donald Finck, Sandy (I) Krivit, Harry Meehan, Ted Truesdell, Rosemary (I) Whiteford, Denise -* i ((SignatuFe) Round 1 / Round 2 Round 3 • • • BALLOT COUNTRY CLUB ADVISORY BOARD April 19, 2007 Vacancies: 3 Requirements: 1 must be pool member, 1 must be tennis member (I) = Incumbent Archetti, John (I) Becker, Susan Begin, Jon Cassady, Donald Fin , Sandy (I) Krivit, Harry Meehan, Ted Truesdell, Rosemary (I) Whiteford, Denise (Signature) Round 1 Ac / Round 2 Round 3 / i oit( s • • CLERK'S TALLY SHEET LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Round 1 Maurer, Robert 1 Ryan, Susan / l l i Sullivan, Patty (I) /PO' Whiteford, Denise (Signature) Round 2 Round 3 • • • BALLOT LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Maurer, Robert Ryan, Susan Sullivan, Patty (I) Whiteford, Denise `— (Signature) Round 1 Round 2 Round 3 • • • BALLOT LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Maurer, Robert Ryan, Susan Sullivan, Patty (I) Whiteford, Denise (Signature) Round 1 Round 2 Round 3 • • • BALLOT LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Round 1 Round 2 Round 3 Maurer, Robert V Ryan, Susan Sullivan, Patty (I) Y Whiteford, Denise • • • BALLOT LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Maurer, Robert Ryan, Susan Sullivan, Patty (I) Whiteford, Denise (8ignature) Round 1 Z / Round 2 Round 3 • • • BALLOT LIBRARY ADVISORY BOARD April 19, 2007 Vacancies: 2 total Maurer, Robert Ryan, Susan Sullivan, Patty (I) Whiteford, Denise Round 1 / / Round 2 Round 3 CLERK'S TALLY SHEET RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Round 1 Beach, Paul (I) Finney, Mark (I) Mahoney, Brian (I) Stone, Carolyn (I) Vandersluis, Jan Whiteford, Denise (Signature) (Signature) • Round 2 Round 3 • • BAL LOT RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Round 1 Beach, Paul (I) V Finney, Mark (I) b/' - Mahoney, Brian (I) V Stone, Carolyn (I) .. Vandersluis, Jan Whiteford, Denise (Signature) Round 2 Round 3 • • • BALLOT RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Beach, Paul (I) Finney, Mark (I) Mahoney, Brian (I) Stone, Carolyn (I) Vandersluis, Jan Whiteford, Denise (Signature) Round 2 Round 3 • • • BALLOT RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Round 1 Beach, Paul (I) /eG Finney, Mark (I) Mahoney, Brian (I) 96 1- / Stone, Carolyn (I) &tg Vandersluis, Jan /1LT Z Whiteford, Denise dt., (Signature) Round 2 Round 3 • • • BALLOT RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Beach, Paul (I) Finney, Mark (I) Mahoney, Brian (I) Stone, Carolyn (I) Vandersluis, Jan Whiteford, Denise Round 1 Round 2 Round 3 BALLOT RECREATION ADVISORY BOARD April 19, 2007 Vacancies: 4 total (2 regular and 2 alternate) (I) = Incumbent Beach, Paul (I) Finney, Mark (I) Mahoney, Brian (I) Stone, Carolyn (I) Vandersluis, Jan Whiteford, Denise • Round 1 V X Round 2 Round 3 FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME -FIRST NAME -MIDDLE NAME NAME OF BOARD, COUNCIL, COMMISSION, AUTHORITY, OR COMMITTEE Eissey, Edward M. Village Council of North Palm Beach MAILING ADDRESS 501 U.S. Highway 1 CITY COUNTY North Palm Beach Palm Beach 1 DATE ON WHICH VOTE OCCURRED 4/19/07 THE BOARD, COUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON WHICH I SERVE IS A UNIT OF: CITY ❑COUNTY ❑ OTHER LOCAL AGENCY NAME OF POLITICAL SUBDIVISION* Vi11a§e of NortPalm Beach MY POSITION IS: WHO MUST FILE FORM 8B g ELECTIVE ❑ APPOINTIVE This form is for use by any person serving at the county, city, or other local level of government on an appointed or elected board, council, commission, authority, or committee. It applies equally to members of advisory and non -advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before completing the reverse side and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which inures to his or her special private gain or loss. Each elected or appointed local officer also is prohibited from knowingly voting on a mea- sure which inures to the special gain or loss of a principal (other than a govemment agency) by whom he or she is retained (including the parent organization or subsidiary of a corporate principal by which he or she is retained); to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one -acre, one -vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister, father-in-law, mother-in-law, son-in-law, and daughter-in-law. A "business associate" means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange). ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must disclose the conflict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting; and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the min- utes of the meeting, who should incorporate the form in the minutes. APPOINTED OFFICERS: Although you must abstain from voting in the situations described above, you otherwise may participate in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN: • You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting, who will incorporate the form in the minutes. (Continued on other side) CE FORM 8B - EFF. 1/2000 PAGE 1 APPOINTED OFFICERS (continued) • A copy of the form must be provided immediately to the other members of the agency. • The form must be read publicly at the next meeting after the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the agency, and the form must be read publicly at the next meeting after the form is filed. I, Edward M. Eissey DISCLOSURE OF LOCAL OFFICER'S INTEREST , hereby disclose that on April l.f (a) A measure came or will come before my agency which (check one) inured to my special private gain or loss; inured to the special gain or loss of my business associate, inured to the special gain or loss of my relative, inured to the special gain or loss of whom I am retained; or inured to the special gain or loss of is the parent organization or subsidiary of a principal which has retained me. (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: My brother, Thomas Eissey, ?"as a candidate -`or a position on the Vi11_one's Construction Board of Adjustment & Appeals. 677/0 Ai/ / Date Filed Signature ,20 07 , by , which NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $10,000. CE FORM 88 - EFF. 1/2000 PAGE 2 FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME -FIRST NAME -MIDDLE NAME NAME OF BOARD, COUNCIL, COMMISSION, AUTHORITY, OR COMMITTEE A) I(bP, e i , D Pt R (L`/ 1— C— v) LL-Pt E c.�v e� C.1 L MAILING ADDRESS THE BOARD, COUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON t' it 0 IA A 1 NC' , , 111 / k j — IN-T i �W/HICH I SERVE IS A UNIT OF: CITY W (T I COUNTYv`C1 I ➢ l(CITY 0 COUNTY 0 OTHER LOCAL AGENCY ?JOR- -1 PRZ. P cN PA -al Jac=..ACA 1 DATE ON WHICH VOTE OCCURRED d--t —19 — 01 NAME OF POLITICAL SUBDIVISION: YJ Ti-; ? A-t_1"1 9P E.1\04- MY POSITION IS: y ELECTIVE WHO MUST FILE FORM 8B 0 APPOINTIVE This form is for use by any person serving at the county, city, or other local level of govemment on an appointed or elected board, council, commission, authority, or committee. It applies equally to members of advisory and non -advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before completing the reverse side and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which inures to his or her special private gain or loss. Each elected or appointed local officer also is prohibited from knowingly voting on a mea- sure which inures to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the parent organization or subsidiary of a corporate principal by which he or she is retained); to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one -acre, one -vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister, father-in-law, mother-in-law, son-in-law, and daughter-in-law. A "business associate" means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange). * ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must disclose the conflict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting; and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the min- utes of the meeting, who should incorporate the form in the minutes. * APPOINTED OFFICERS: * Although you must abstain from voting in the situations described above, you otherwise may participate in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN: • You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting, who will incorporate the form in the minutes. (Continued on other side) CE FORM 8B - EFF. 1/2000 PAGE 1 APPOINTED OFFICERS (continued) • A copy of the form must be provided immediately to the other members of the agency. • The form must be read publicly at the next meeting after the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the agency, and the form must be read publicly at the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST I, _ DA v , hereby disclose that on A -PR. I ,20Q1: (a) A measure came or will come before my agency which (check one) inured to my special private gain or loss; inured to the special gain or loss of my business associate, inured to the special gain or loss of my relative, inured to the special gain or loss of whom I am retained; or inured to the special gain or loss of is the parent organization or subsidiary of a principal which has retained me. (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: l�- (A-J D1 A-T - 5 b/ W I F E. 7/o4t)D"7 Date Filed GAs Signature by , which NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $10,000. CE FORM 8B - EFF. 1/2000 PAGE 2