HomeMy WebLinkAboutGuerraEdgar Affidavit Disclosure 2009 jQH1
OFFICE OF THE CITY ATTORNEY
MEMORANDUM
_ -
TO: JUDY HORNING, LPD
c _- `CJ
FROM: JOHN M. ROBERTS i Deputy City Attorney F-
r-
DATE: NOVEMBER 30, 2009
SUBJECT: OUTSIDE EMPLOYMENT DISCLOSURE AFFIDAVITS FOR LPD
OFFICER
I am herewith returning to you the Affidavit of Disclosure form forwarded to me for Officer Edgar
Guerra because it does not contain a disclosure of any activity for the Ethics Board to review. It
appears from the signature on the second page that I may have been forwarded parts of two different
affidavits,but I cannot read the signature so I do not know for sure. The signature may be that of the
notary. If it is all Officer Guerra's affidavit and the intent is to have the Ethics Board review the
officer's outside employment for possible conflicts of interest,the Board needs to have a sufficient
description of the outside work to perform its assigned task.
To assist in this regard, my secretary e-mailed you previously the attached form used by elected
officials and department heads. It is a good guideline for description of outside employment and its
disclosure. I would request on behalf of the Ethics Board that Officer Guerra fill out the additional
form as part of his disclosure affidavit.
Thank you for your assistance.
JMR/sp
Attachment
cc: Ethics Board-c/o City Clerk
Brig Smith
i
S:Wttorney StafflBOARDS&COMMITTEES\Ethics MHorning outside employment Guerra.doc
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CITY OF LANSING
AFFIDAVIT OF DISCLOSURE NOVri � I
DAT' : 111�3I0q
T0: CITY CLERK, Larl5ing CRY Aftorney ,
CITY ATTORNEY, or
BOARD OF ETHICS
I a i`� ��le(�p�� make the following disclosure under oath:
(Name)
PLEASE CHECK THE APPROPRIATE BOX OR FILL IN THE BLANKS FOR EACH OF THE
FOLLOWING ITEMS
No
1 ❑ I am an ❑ elected or ❑ appointed:5 officer or ❑ employee of the City of
Lansing holdinLIT(
he position of Police 0K-scf2 in the
department
ElI am an immediate family member related to an elected or appointed
officer or employee of the City of Lansing named in the
holding the position of
department.
❑ bK I am a Business Associate of an elected or appointed officer or employee
of the City of Lansing named in the
Holding the position of
Department.
2. ❑ I may derive income or benefit directly from a contract with the City or from
any City action detailed below. (Charter 5-505.1)
❑ I may have a conflict between a personal interest and the public interest,
the nature of which is disclosed below (Charter 5-505.2) [Chapter
#290.04(I) of the Code of Ordinances]
❑ 1 may have a financial interest in a matter proposed to be acted upon by
the City of Lansing as described below [Chapter 290.04(I) of the Code of
Ordinances]
❑ { I make this disclosure because of a possible appearance that I may be in
violation of or in conflict with the City of Lansing Ethics Ordinance as
provided for in the Code or Ordinances and in the City Charter
3. This position is: ❑ Full time i<Part time (less than 25 hours/wk) ❑ Unpaid
4. My Address is:
5. My Business (daytime) Phone # is:
CONTINUED ON PAGE 2
AFFIDAVIT OF DISCLOSURE-PAGE 2
6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S) FOR SUBMITTING THIS
DISCLOSURE AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST.
/uoT- e ; . 1
1, c
I hereby certify that this disclosure is complete and accurate to the best of my knowledge,
information and belief.
The foregoing Affidavit of Disclosure was executed on this « day of
NDV , 20_2-L__,
Signed
State of Michigan, County of
Subscribed and sworn to before me this /� day of �J01161YA Fe A 2009
Notary Public%r Deputy Clerk
County, Michigan
My Commission Expires:
PLEASE INCLUDE AND SUBMIT A COPY OF YOUR CURRENT JOB DESCRIPTION
DRAFT 5A;REVISED 11.05.04
Please provide additional information about your outside business or eimployment. Of special
interest to the Board is bow the activities of the business or einployment play directly or
indirectly affect the City. This disclosure is about information and is not an indication of any
anticipated conflict of interest or suspected wrongdoing. Therefore, please describe for the
Board what it is you actually do and be detailed and specific. You are not required to limit your
disclosure only to the following questions. For each business, include in your answer such
things as;
■ What is the forin of your business entity and what percentage do you own?
■ Are you self-employed?
Wino is your employer, if applicable?
■ What are the things you actually do in the business?
■ Who are your clients and who receives your goods or services?
■ How and where are your services performed?
■ How often do you do outside work?
I
■ Does your business or employer contract with the City?
■ In performing your business or outside employment, do you use any City facilities or
equipment? If so, describe:
■ Is any of your business or employment conducted in the City? If so, describe:
■ Does your business advertisement or circulars, if any, contain any reference to the City or
Your City employment?
■ Is there any additional information that you believe would assist the Ethics Board in its .
review of your business or personal activities for potential conflicts of interest?
If so, please describe:
In providing this additional information, the Board of Ethics asks that you give special attention
to the Conflicts of Interest section of the Charter found at 5-505.1 — 5-505.3. A copy is enclosed
for your convenience.