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05/11/2010NEIGHBORHOOD & AFFORDABLE HOUSING ADVISORY BOARD MEETING MINUTES CITY OF CLEARWATER May 11, 2010 Present: Kip Corriveau Peggy M. Cutkomp Laurel E. Braswell Lisa Hughes William R. Griffiths Linda Kemp Absent: Donald F. Brackett Chair Vice-Chair Board Member Board Member Board Member Board Member Board Member Also Present: Geri Campos Lopez Economic Development & Housing Director Jim Donnelly Economic Dev & Housing Assistant Director Michael Holmes Housing Manager Patricia O. Sullivan Board Reporter The Chair called the meeting to order at 9:00 a.m. at City Hall. To provide continuity for research, items are in agenda order although not necessarily discussed in that order. 3 - Approval of Minutes - April 14, 2010 Member Griffiths moved to approve the minutes of the regular Neighborhood and Affordable Housing Advisory Board meeting of April 14, 2010, as recorded and submitted in written summation to each board member. The motion was duly seconded and carried unanimously. 4 - FY 2010/11 Consolidated Action Plan Application Recommended Allocations Housing Manager Michael Holmes reviewed the Consolidated Action Plan Application process, limits, and TRC (Technical Review Committee) recommended allocations, which are based on a projection of grant revenue estimates. Funding for Pinellas Coalition for the Homeless is subject to budgeted General Revenue funds. If the agency is funded through another source, the proposed allocation will be made available to the next agency (Religious Community Services - Grace House), based upon ranking scores. See Exhibit: CAP ALLOCATION RECOMMENDATIONS - NAHAB 2010-05-11 Mr. Holmes said the public comment period will begin in two weeks. The City Council will need to approve the funding before the plan is submitted to HUD (Housing & Urban Development). Distribution of funds will begin on October 1, 2010. Housing education and housing pool funds will be distributed on a first come, first serve basis. Tampa Bay CDC funding is based on a fee service. The State will not supply SHIP (State Housing Initiatives Partnership) funds this year; the City has some remaining SHIP funds on hand. Economic Development & Housing Director Geri Campos Lopez said administration costs for infill and rehab are listed separately. Neighborhood & Affordable Housing 2010-05-11 Member Griffith moved to recommend approval of the Public Facilities and Improvements funding as proposed. The motion was duly seconded and carried unanimously. Members Griffith and Corriveau declared conflicts of interest related to Public Services funding. Member Hughes moved to recommend approval of the Public Services funding as proposed. The motion was duly seconded. Members Cutkomp, Braswell, Hughes, and Kemp voted "Aye." Member Griffith and Chair Corriveau abstained. Motion carried. Member Kemp declare a conflict of interest related to funding for Housing. Member Braswell moved to recommend approval of Housing Pool funding as proposed. The motion was duly seconded. Members Cutkomp, Braswell, Hughes, and Griffiths and Chair Corriveau voted "Aye." Member Kemp abstained. Motion carried. Member Braswell moved to recommend approval of funding for the remaining allocations. The motion was duly seconded. Members Cutkomp, Braswell, Hughes, and Griffiths and Chair Corriveau voted "Aye." Member Kemp abstained. Motion carried. 5 - New/Old Business: None. 6 - Next Meeting - June 8, 2010 7 - Adjourn The meeting adjourned at 9:25 a.m. Attest: Chair, N hborhood & Affordable Housing Advisory Board Board Reporter Neighborhood & Affordable Housing 2010-05-11 2 EXHIBIT: CAP ALLOCATION RECOMMENDATIONS NAHAB 2010-05-21 - - ins A Amount Amount Amount AGENCY ADDRESS PURPOSE Rey Requested Proposed Proposed Total CDBG HOME Public Facilities and Im rovements Communit Pride Child Care Centers 1235 Holt Avenue Clearwater Buildin Renovations and re airs Y ~ 9 P $587000.00 $587000.00 Reli ious Communit Services Inc. -The Havens 503 S. Dr. Martin Luther Kin Jr Avenue Clearwter Buildin Renovations and re airs g Y g, 9 P Reli ious Communit Services Inc. -Grace House 503 S. Dr. Martin Luther Kin Jr Avenue Clearwter Buildin Renovations and re airs $537306.00 $537306.00 $407000.00 $407000.00 g Y g, 9 P Directions for Mental Health Inc. - Center Im rovements 1437 S. Belcher Rd Clearwater Buildin Renovations and re airs P 9 P $237500.00 Jr. Lea ue of Clearwater -Dunedin 1265 Ba shore Blvd Dunedin Buildin Renovations and re airs ' 9 Y 9 P $4077000.00 AI ha House of Pinellas 701 5th Avenue. St. Petersbur Buildin Renovations and re airs p 9 9 P Martin Luther Kin Nei hborhood Famil Center Inc. 1201 Dou las Avenue Clearwater Buildin Renovations and re airs ' $747800.00 $1957000.00 $1957000.00 g g Y g 9 P Subtotal ' $8517606.001 $3467306.001 Public Services Reli ious Communit Services -Grace House 503 S. Dr. Martin Luther Kin Jr. Avenue Clearwater Salaries and o eratin ex enses g Y g, P g P $307000.00 Willa Carson Communit Health Resource Center 1108 N. Martin Luther Kin Jr. Avenue Clearwater Salaries and o eratin ex enses Y g, P g P Pinellas Coalition for the Homeless 5180 62nd Avenue N Pinellas Park Salaries and o eratin ex enses $607000.00 $307000.00 $257000.00 $127500.00 P g P Pinellas 0 ortunit Council -Chore Services 4039 8th Avenue South St. Petersbur Florida Salaries and o eratin ex enses Pp Y g, P g P $607000.00 $307000.00 Homeless Emer enc Pro~ect -Emer enc Shelter 1120 North Bett Lane Clearwater Salaries and o eratin ex enses 9 Y J g Y Y~ P g P $307000.00 $127000.00 Clearwater Homeless Intervention Pro~ect -Emer enc Shelter 1339 Park Street Clearwater Salaries and o eratin ex enses J g Y ~ P g P Westcare of Florida 1735 Dr. Martin Luther Kin Jr. Avenue South St. Petersbur Salaries and o eratin ex enses 9, g P g P $757000.00 $307000.00 $307000.00 $127000.00 Personal Enrichment Throu h Mental Health Services -Emer .Treatment Ctr 11254 58th Street North Pinellas Park Salaries and o eratin ex enses g g P g P $77000.00 $27800.00 Kimberl Home Inc. -Infant & Toddler Care 1189 N. E. Cleveland Street Clearwater Salaries and o eratin ex enses Y P g P $587000.00 Safet Harbor Nei hborhood Famil Center Inc. 1003 Dr. Martin Luther Kin Jr. St. N Safet Harbor Salaries and o eratin ex enses Y g Y ~ 9> Y P g P Intercultural Advocac Institure 612 Franklin Street Clearwater Salaries and o eratin ex enses Y P g P $197803.00 $77921.00 $427007.00 Catholic Charities 121316th Street North St. Petersbur Salaries and o eratin ex enses g P g P $507000.00 211 Tam a Ba Cares 50 South Belcher Rd. Suite 116 Clearwater Salaries and o eratin ex enses P Y P g P $307000.00 * Funding for Pinellas Coalition for the Homeless is subject to budgeted General Revenue funds. If agency is funded through another source, the proposed allocation will be made available to next agency based upon ranking scores. $0.00 Fair Housin -Administration Gulf Coast Le al Services 641 First Street St. Petersbur Fair Housin Education and Foreclosure Prevention 9 9 g n $437969.00 $267381.00 Communit Service Foundation 925 Lakeview Rd. Clearwater Fair Housin Education and Foreclosure Prevention Y ~ g n $157000.00 $77500.00 (AMOUNT AVAILABLE _ $130,642 -13% of CDBG Allocation) Subtotal ' $5757779.001 $1717102.00 AGENCY ADDRESS PURPOSE Amount Amount Amount Re u q Requested Total Proposed CDBG Proposed HOME Cit of Clearwater Administration - CDBG ' Y Cit of Clearwater Administration -HOME Y $2007987.00 $567505.00 Subtotal ' $2577492.00 $2007987.00 $567505.00 Economic Develo ment Cit of Clearwater - ED Pro ram Delive Y 9 rY $107000.00 $107000.00 Subtotal $107000.001 $107000.001 Ac uisitionllnfill Housin Ac uisition of Real Pro ert Cit Pro~ect q p Y Y J Cit of Clearwater Infill Housin Pro ram Delive $0.00 $257000.00 $257000.00 Y 9 g rY Subtotal $257000.001 $257000.001 Rehabilitation Cit of Clearwater &Housin Pool -Rehabilitation Y 9 Cit of Clearwater Rehabilitation -Pro ram Delive ' Y 9 rY $1407000.00 $1407000.00 Subtotal ' $1407000.001 $1407000.001 Relocation Cit of Clearwater Relocation Pro ram Y 9 $0.00 Subtotal $0.001 1 Demolition Cit of Clearwater Demolition Pro ram Y 9 $0.00 Subtotal $0.00 HOUSING Education Pool Total Allocation to Education Pool Tam a Ba CDC - Homeownershi Counselin Pro .IPre & Post Purchase 2139 N. E. Coachman Rd. Clearwater Housin Counselin Pro ram P Y P g g g g 9 $297000.00 Tam a Ba CDC - Homeownershi Counselin Pro .IPre & Post Purchase 2139 N. E. Coachman Rd. Clearwater S ace Rental Fee -Housin Counselin Pro ram P Y P g g p 9 9 g Communit Service Foundation - Partnershi To Ownershi Pro ram 925 Lakeview Rd. Clearwater Housin Counselin Pro ram Y P p 9 g g 9 $4,200.00 $27000.00 Communit Service Foundation - Homebu er Education Pro ram 925 Lakeview Rd. Clearwater Housin Counselin Pro ram Y Y g ~ g g 9 $4,200.00 Clearwater Nei hborhood Housin Service -Housin Education Pro ram 608 N. Garden Avenue Clearwater Default- Foreclosure Prevention Pro ram g g g 9 9 $497896.00 Subtotal $897296.001 1 Amount Amount Amount AGENCY ADDRESS PURPOSE Re u q Requested Total Proposed CDBG Proposed HOME Housin Pool - SF - DPA Infill Rehabilitation $1117542.00 $4237791.00 - Tam a Ba Communit Develo ment Cor oration 2139 N. E. Coachman Rd. Clearwater General Housin Pool p Y Y P P , g -Tam a Ba Communit Develo ment Cor oration 2139 N. E. Coachman Rd. Clearwater Loan Processin Service p Y Y P P , g $187000.00 - Lar o Area Housin Develo ment Cor oration 2139 N. E. Coachman Rd. Clearwater General Housin Pool g 9 p P g -Clearwater Nei hborhood Housin Services Inc. 608 N. Garden Avenue Clearwater Rehabilitation Pro ram -Pro ram Delive ' g 9 g 9 rY $1007000.00 -Clearwater Nei hborhood Housin Services Inc. 608 N. Garden Avenue Clearwater Down P mnt and Closin Cost Assistance -Pro .Delive ' g 9 Y g g , -Pinellas Habitatfor Humanit 3071 118th Avenue North Clearwater General Housin Pool ' Y ~ g ve $1007000.00 $5007000.00 Subtotal ' $7187000.001 $1117542.001 $4237791.00 HOME Pro ram - CHDO Set-Aside 15% of Allocation $847758.00 $847758.00 TOTALS $2 $277517931.001 $170047937.001 $5657054.00 Revitalization Strate Area and a CBDO would not be sub~ect to the Am gY ~ J Amt. Available $170047937.00 $565,054.00 Public Service ca of 15%forother PublicServices. Bal. p Bal. Remaining $0.00 Total Estimated Funding REVENUES CDBG -Grant $170047937.00 CDBG -Est. Pro ram Income 9 HOME -Grant $0.00 $5657055.00 HOME -Est. Pro ram Income g $217530.00 SHIP -Grant SHIP -Est. Pro ram Income $0.00 $0.00 FORM 813 MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LA T AME-FIRST NA E- I MIDDL NAME l ?' T) K ? JEF E OF BOAR =Q?MISSI THORI OR COMMI r U MA DD SS ? ? l? ll(1 /.?v141f- V THE BOA COUNCIL, COMMISSION, AUTHbRfry OR COMMITTEE ON HIC I SERVE IS A UNIT OF: i CI Y COUNTY ? N ? COUNTY ? OTHER LOCAL AGENCY MAM? OF POLITICAL SUBDIVISION: DAT I H V OCCUR MY POSITION IS: ? ELECTIVE APPOINTIVE WHO MUST FILE FORM 813 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 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. 112000 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. DISCLOS RE OF LOCAL OFFICER'S INTEREST hereby disclose that on 20 ) 0 (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 by whom I am retained; or inured to the special gain or loss of which 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: ` Date Filed Signature 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 FORM 813 MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME-FIRST NAME-MIQIIL€ NAME NAME F BO RD, CO NAIL, COMMISSION, AUTHORITY, OR COMMITTEE s I/7J (/ WA, X, 0 MAILINGDDRE s ?? V f? [ THE BOARD, COUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON WHICH I SERVE IS A UNIT OF: (0 CITY UNTY CITY El COUNTY ? OTHER LOCAL AGENCY NAME OF iTICAL SUBDI N: let DATE ON WHI Hf VOTE OCCURRED MY POSITION IS: 6) ?// r / 26 / n ? ELECTIVE VAPPOINTIVE WHO MUST FILE FORM 813 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 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 813 - 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, / /7 r ((-, hereby disclose that on 20 (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 by whom I am retained; or - inured to the special gain or loss of , which 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: -1a 0- r t- 8 - Cep- 61 4? P(',ie ?/a5- r,4 ??. / /?- (01? '0?" ?/' ?' / U Z6 Date Filed ianature 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 813 - EFF. 1/2000 PAGE 2 FORM 813 MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NA FIRS ME- IDD E NAM NAME OFBOARD, CO,INCIL, COMMISSION, AUTHORI , OR COMMITTEE /I MAILING ADDRESS ryry THE BOARD, COUNCIL, COMMISSIO , AUTHORITY OR COMMITTEE ON C1 S S h 1?1 1 WHICH I SERVE IS A UNIT OF: CITY UNTY El CITY ? COUNTY THER LOCAL AGENCY ` r ,1? NAME OF POLITICAL SUBDIVISION: DATE ON WHICH VOTE O CURRED 0 t 2 MY POSITION IS: 0 L T V TI E o , I E APPOIN V E EC WHO MUST FILE FORM 813 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 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 r, hereby disclose that on ( al?? zc 20 C (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: I t ,2 o t> Date Filed by which Signature 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 813 - EFF. 1/2000 PAGE 2