HomeMy Public PortalAbout02-15-2024 - Conflict of Interest Statement MEMO
CITY OF RICHMOND
50 NORTH 5TH STREET
.,. .,.. .,.. ,,
RICHMOND, INDIANA 47374
r. Ti...-t,,, ) Ronald Oler, Ph.D., Mayor
* 14.00741i:* Department of Law
', ,otwifor ' Andrew J. Sickmann, City Attorney
Kimberly A. Vessels,Assistant City Attorney
. ,
Date: February 9, 2024
To: Board of Public Works and Safety Members:
Emily Palmer, President
Matt Evans, Member
Jamie Lopeman, Member
\i÷
From: Kim Vessels, Assistant City Attorney
Re: Conflict of Interest Disclosure Statement
(Greg Moore, Fire Department)
Attached is a Conflict of Interest Disclosure Statement signed by Greg
Moore as member of the Richmond Fire Department, submitted in accordance
with Indiana Code 35-44.1-1 et seq. This form must be accepted in a public
meeting.
I would ask the Board to make a motion to accept the disclosure statement
as submitted. It does not need to be signed by the Board. If you have any
questions, please contact me at kvessels@richmondindiana.gov.
Thank you,
Kimberly A. Vessels
Assistant City Attorney
'
UNIFORM CONFLICT CJF INTEREST DISCLOSURE STATEMENT
State Form 54266 236
STATE BOARD OF ACCOUNTS
Indiana Code 3S-44.1'1-4
A public servant who knowingly or intentionally has a pecuniary interest inor derives a profit from
a contract or purchaseconnectedvvithonaoUonbythegovnmmento| entityaen/mdbyth* pub|inaervant
commits conflict of interest, o Class D Felony. A public servant has o pecuniary interest in e contract or
purchase if the contract or purchase will result or is intended to result in on ascertainable increase in the'
income or net worth of the public servant or a dependent of the public servant. "Dependent" means any
of the following: the spouse of public servant; o chi|d, ntepchi|d, or adopteo (as defined in |C 31-9
of a public servant who is unemanoipated and |eaa than eighteen of age; and any individual
more than one-half(1/2) of whose support is provided during a year by the public servant.
The foregoing nniata only ofexcerpts from |C 35~44.1-1'4. Cana should betaken to review |C
35-44.1'1'4 in its entirety.
1. Name and Address of Public Servant Submitting Statement:Z-7/ZE6`G,) OOOLL:-
.�
2. Title or Position VVith Governmental Entity� /�)4z����i�c� �~H�3E r-
3. a. Governmental Entity:'
b. County:
4. This statement is submitted (check nne):
e._ as m "single transaction" disclosure statement, as to my financial interest in a specific contract or
purchase connected with the governmental entity which | oervm, proposed to be made by the
ovemmente|entity with or from o particular contractor or vendor; or
b�/ as an "annual" disclosure statement, as to my financial interest connected with any contracts or
purchases of the governmental entity which I serve, which are made on an ongoing basis with or
from particular contractors orvendors.
5. Name(s) ofContractor(s) nrVendor(s):
LL �� 0 0 ��S. Description(s) of Contract(s) or Purchase(s) (Describe the kind of contract involved, and the
effective date and teirmnf the contract m purchase if reasonably determinable. Dates required if4(a)
/a selected above. If"dependent"is involved, provide dependent's name and relationship.):
cy-' r- \�� - ^�~' ^~ \
Page Irvn
7. Description of My Financial Interest (Describe in what manner the public servant or "depen-
dent"expects to derive a profit or financial benefit from, or otherwise has a pecuniary interest in,
the above contract(s) or purchase(s); if reasonably determinable, state the approximate dollar,
value of suc�proflt or benefit
(Attach extra pages if additional space/cnmeced]
8. Approval of Appointing Officer by
an elected public servant or the board of trustees of a state-supported college or university.):
| (VVm) being the of
(Title of Officer or Name of6ovecn/nDBody)
and having the power to appoint
(Name ofGnve/n/nonba/Entity)
the above named public servant tothe publicposition to which heor she holds, hereby approve the
participation to the appointed disclosing public servant in the above described contract(s) or
purchase(s) in wNnh said poh|io servant has a conflict of interest as defined in Indiana Code 35'
44.1'1'4; however, this approval does not waive any objection to any conflict prohibited by statute,
rule, or regulation and is not to be construed as a consent to any illegal act.
Elected Official Office
0. Effective Dates (Conflict of interest statements must be submitted to the governmental entity prior:
bo final action on the contract orpunchoomj:
_
Date Submitted (n*nm'ue»yea� DatnufA�ionunCon�o�prPu�h�sakncmot��year)
Page eovo
10 Affirmation of Public Servant: This disclosure was submitted to the governmental entity and
accepted by the governmental entity in a public meeting of the governmental entity prior to final
action on the con act or purchase. I affirm, under penalty of perjury, the truth and completeness of
the statements made above, and that I am the above named public servant.
Signed: 6n
1)-A 013\-
(Signature of Public Servant)
February 12, 2024
Date:
(month, day, year)
Printed Name: 6-1?-6-6.)c-, H 00,LE
(Please print legibly.)
Email Address: (-.) (r,,g_g_rs Q c n 50Q
Within fifteen (15) days after final action on the contract or purchase, copies of this statement must be
filed with the State Board of Accounts by uploading it here https://gateway.ifionline.org/sboa coi/which is
the preferred method of filing, or by mailing it to the State Board of Accounts, Indiana Government Center
South, 302 West Washington Street, Room E418, Indianapolis, Indiana, 46204-2765 and the Clerk of the
Circuit Court of the county where the governmental entity took final action on the contract or purchase.
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