HomeMy WebLinkAboutHadzajilic-LiskiewiczLana Affidavit Disclosure 2015 y�N S 1 �C
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CITY OF LANSING---BOARD OF ETHICS
February 16, 2015
Lana Hadzajilic-Liskiewicz
Dear Ms. Hadzajilic-Liskiewicz:
Thank you for submitting an Affidavit of Disclosure. At its regular meeting held on February 10,
2015, the Board of Ethics made the following determination:
Your disclosure complies with the disclosure requirement in the City of Lansing
Ethics Ordinance and is received and placed on file by the Board. Further, based on
the information you provided, the Board finds no violation of the City of Lansing
Ethics Ordinance, and your submission of this information in consideration of a
potential appearance of a conflict is appreciated.
If you have any questions with regard to this determination, please feel free to contact me. My office
number is (517) 483-4131.
Sincerely,
Chris Swope, CMMC, CMC
Lansing City Clerk
Lansing City Clerk's Office
Ninth Floor, City Hall, 124 W. Michigan Ave., Lansing, MI 48933-1695
517-483-4131 • 517-377-0068 FAX
www.lansingmi.gov/clerk 9 clerk@lansingmi.gov
t'•NSI �
v G LANSING POLICE DEPARTMENT
120 West Michigan Avenue
�• Lansing, MI 48933
Phone: (517)483-4600 (TDDNoice)
r P Fax: (517) 377-0162 •
CHIC
Virg Bernero, Mayor Chief Mike Yankowski
To: Don Kulhanek
From: Lt. Cherie Ballor
Re: Supplemental Employment
Date: January 20, 2015
Attached is a Supplemental Employment Affidavit of Disclosure for Detention Officer Lana Hadzajlic-Liskiewicz.
Please present to the Ethics Board and forward me a copy of the Ethics Board determination.
Thank you for your attention to this matter, Any questions please feel free to contact me.
r
Lieutenant Cherie Ballor
Lansing Police Department
Central Services
1
(517) 483-4647 -
"POLICE& COMMUNITY PARTNERSHIPS FOR PROGRESS&EXCELLENCE"
"Equal Opportunity Employer
CITY OF LANSING Rt -Iw'�' `V I`l
l ,1. �.. ..� L V J
AFFIDAVIT OF DISCLOSURE
2t15J uN 30 P I�i 1-- 32
/� nn DATE:
TO: CITY CLERK,
CITY ATTORNEY, or
BOARD OF ETHICS
1MULh7Cl if IC- �Su�w►C7 make the following disclosure under oath:
(Name)
PLEASE CHECK THE APPROPRIATE BOX OR FILL IN THE BLANKS FOR EACH OF THE
FOLLOWING ITEMS
Yes No
1. �' ❑ I am an ❑ elected or ❑ appointed ❑ officer or V'employee of the City of
Lansing holding t e position of U,- in the
tJrt bl G� Oft(� department
❑ �a 1 am an immediate family member related to an elected or appointed
officer or employee of the City of Lansing named
holding the position of in the
/ department.
❑ �a' I am a Business Associate of an elected or appointed officer or employee
of the City of Lansing named
Holding the position of in the
Department.
2. ❑ 1 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(1) of the Code of Ordinances]
❑ I 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]
❑ E 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 i!z- ars/wk) ❑ Unpaid
4. My Address is
5. My Business (aayiime) rnone # 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.
tee, r 6 U
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L12-2 14tO,0, C v
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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
Jccr'\ 20 l5
Signed
State of Michigan, County of Subscribed and swornme this day of Jan n 20
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CpUFMOF� ,� a County, Michigan
WWae m Expku JJUN e,2017 C-
A I In 1M Em y d My Commission Expires:
PLEASE INCLUDE AND SUBMIT A COPY OF YOUR CURRENT JOB DESCRIPTION
DRAFT 5A;REVISED 11.05.04
ATTACHMENT A
Please provide additional information about your outside business or
employment. Of special interest to the Board is how the activities of the business
or employment may 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 form of your business entity and what percentage do you
own? 'yam
■ Are you self-employed? vju, "
■ Who is your employer, if applicable? �Vl,v`zw"' I-LiI I-) TV-0
■ 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?
- f7V�- yye�ti�V�Gi d"�'i;r�� � �i"L{ G7//�y,►�5 4 1/�.�
Page 1 of 3
■ How often do you do outside work?
�1Y Yl q Q y"Gt,(.l a k
�r
■ Does your business or employer contract with the City?
■ In performing your business or outside employment, do you use any City
facilities or equipment? N D If so, describe:
■ Is any of your business or employment conducted in the City? Iks If so,
describe: k/ 2 df'tlyt/LV A-C
■ Does your business advertisement or circulars, if any, contain any
reference to the City or your City employment?
■ If your business uses advertisements, circulars, applications, or order
forms that you have designed or have had designed for you, please attach
a copy of the applicable form(s). y1--/G\�
Page 2 of 3
■ If you provide training or education as part of your business:
Do you identify yourself to your clients or students as being employed by
the City of Lansing? YN
Do you include in any of the written materials or aids or reference in any
way in your presentations reference to policies, procedures, methods or
materials as being those also used by the City of Lansing? N U If so,
attach a copy of the material or aid and explain the reference in your
presentation.
■ 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.
Page 3 of 3