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AFFIDAVIT OF DISCLOSURE
TO: LANSING BOARD OF WATER & LIGHT: DATE: 9/03/2015
OFFICE OF THE CORPORATE SECRETARY
I Megan Hayward make the following disclosure under oath:
(Name)
PLEASE CHECK THE BOX AND FILL IN THE APPROPRIATE BLANKS FOR EACH OF THE
FOLLOWING ITEMS
Yes No
1. ® ❑ I am an employee of the Lansing Board of Water & Light (BWL)
holding the position of Project Manager in the
Project Engineering Department
❑ X 1 am an immediate family member related to an employee of the
BWL named holding the position of
in the
Department
❑ ® I am a Business Associate of an employee of the BWL named
holding the position of
in the
Department.
2. ❑ x I may derive income or benefit directly or indirectly from the bidding of,
negotiation of, solicitation of or entry into a contract with the BWL
(disclosed below in item #4)
❑ IN I may have a conflict between a personal interest and the public
interest (disclosed below in item #4)
❑ ® I may have a financial interest in a matter proposed to be acted upon
by the BWL (disclosed below in item #4)
X ❑ I make this disclosure because of a possible appearance that I may be
in violation of or in conflict with the BWL Ethics policy
3. My BWL position is:
IN Full-time❑ Part-time (less than 25 hours/wk) ❑ Unpaid
4. PLEASE DESCRIBE IN DETAIL YOUR REASON(S)FOR SUBMITTING THIS
DISCLOSURE AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST.
I am submitting this disclosure due to the fact that my brother-in-law Joshua Hayward is employed by a
vendor(Kent Power)that will be bidding on work for the Board of Water and Light where I am employed.
I will not be involved in evaluating bids and awarding contracts for the type of work Kent Power performs.
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 q day ,of wt bey
2015 .
Signed
State of Michigan, County of Z.a�
Subscribed and sworn to before me this `kT day of S k,.,toc r , 20 i S
Notary Public
County, Michigan
Ac
My Commission Expires: 5- -2
SHONI GALATIAN
NOTARY PUBLIC-STATE OF MICHIGAN
COUNTY OF CLINTON
My Commission Expires Mar.5,2017
Acting in the County of