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HomeMy WebLinkAboutHollisterDavid Affidavit Disclosure 1995 CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ J CITY ATTORNEY and [ ] MAYOR and , DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) lao.,1) being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title) m A-'[o2 in the Department. This position is : Fulltime [ ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) a member of my immediate family as defined in Ordinance 290 . 02 ( i ) , [ ] and/or (Name) -b OE S Ato t- a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c) and (d) : (Select the option or options that apply) [ J a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows : The financial benefit will be received by the following persons in the following amounts: -1.)diS 0) nT ;and/or ( ] b. intend to have business dealings with the City of 1 Lansing, either directly or indirectly. The business dealings are specifically described in detail as follows ( include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest ) : ;and/or [ ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows: The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly , is described as follows : DOES ^to7- 3 N � ;and/or [ ] d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings, the financial. consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest) : Na7' A�ra1 2 ;and/or [ ] e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : o F S PJ e-C-- r The public interest that the personal interest conflicts with is described as follows : 3. I have attached additional detail on the reverse of this form or on attached sheets, including copies of all relevant documents , memos, resolutions, and contracts . SiE A rTi-c -I&Ij 4 . (Select One) [ ] I will not make or participate in the . making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: pF 5 NoT JQaLv ly 5. I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief. 6. I hereby. certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the 12 day of A e Subscribed and sworn before me the day of� 19q, in ` County, Michigan Notary Public/or MARILYNN SLADE Deputy Clerk Notary Public, Ingham County, MI County, Michigan My Comm. Expires Mar. 18, 1999 My Commission Expires : T FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: COPIES SENT TO: [ ] Mayor [ ] City Council President [ J Department Head [ ] Board of Ethics DATE SENT: �— 7- t 1/ B0014 B Y: y- - 2. CC)Urn C'j� C q��(��QL 4 CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ ] CITY ATTORNEY and [ ] MAYOR and , DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) 1�aJ..o e . 4Ltl $ _ being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title) mP-g0 in the Department. This position is: `x] Fulltime ( ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) , a member of my immediate family as defined in Ordinance 290 . 02 ( i ) , [ ] and/or (Name) iv a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c) and (d) : (Select the option or options that apply) [ ] a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows: The financial benefit will be received by the following persons in the following amounts : -L)d ES 03 nT' n44�� ;and/or [ ] b. intend to have business dealings with the City of 1 Lansing, either directly or indirectly. The business dealings are specifically described in detail as follows ( include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest ) : ;and/or [ ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows: The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly, is described as follows : �pES No-r- �/" ;and/or ( ] d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings , the financial consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest ) : o f S nraT- L:02/f 2 ;and/or ( ] e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : J.)o F s go e-r- /� The public interest that the personal interest conflicts with is described as follows : 3. I have attached additional detail on the reverse of this form or on attached sheets, including copies of all relevant documents , memos , resolutions, and contracts . $e& A TTAa-Leo 4. (select One) [ ] I will not make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: FS NdT A4)phl 3 5. I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief. 6 . I hereby. certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the 1-7 day of Am,L 19J-� . l Subscribed and sworn before me the day of 19� in County, Michigan Notary Public/or MARILYNN SLADE r Deputy Clerk Notary Public, Ingham County,MI County, Michigan My Comm. Expires Mar. 18, 1999 My Commission Expires : 3 -1�5 FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: COPIES SENT TO: [ ] Mayor [ ] City Council President [ ] Department Head [ ] Board of Ethics DATE SENT: << Bpar4 BY: '+- - Z Co u/Yl c pA ot' 4 y N S r �G OFFICE OF THE MAYOR 1� 9th Floor,City Hall \ 124 West Michigan Avenue Lansing,Michigan 48933-1694 (517)483-4141 (Voice) (517)483-4479(TDD) (517)483-6066(FAX) cHIG David C. Hollister, Mayor irthday On April 25, 1995 I will b wneroandrGig an annual lian Zucker, General party fundraiser. Tom Dickson, 0 Manager of the Springfield Sultans Minor League baseball team offered, and I accepted, an appearance of the baseball team at the event. No money, no special consideration, no favors were asked, suggested or received. The team offer was an expression of goodwill and an opportunity ear before they are scheduledhe team to ee our city and to move to Lansing• stadium site one y A visit to Sparrow Hospital and a promotion of its Miracle Network Fundraiser is also scheduled that day. I will receive no direct or indirect personal financial benefit from the fundraiser. I file this Affidavit Of Disclosure to alleviate any concerns of a possible conflict of interest. j David C. Hollister Mayor "Equal Opportunity Employer" CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ ] CITY ATTORNEY and [ ] MAYOR and DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) lao..0 e . 41'U STEPL-- being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title) m Pk. 0 in the Department. This position is: x Fulltime [ ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) , a member of my immediate family as defined in Ordinance 290 . 02 ( i ) , [ ] and/or (Name) xrot— a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c) and (d) : (Select the option or options that apply) [ ] a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows : The financial benefit will be received by the following persons in the following amounts : TW I S ;and/or [ ] b. intend to have business dealings with the City of 1 Lansing , either directly or indirectly. The business dealings are specifically described in detail as follows (include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest ) : Lao E.S 007 / ;and/or ( ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows: The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly, is described as follows : '1oE 7 �pR/v ;and/or [ ] d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings , the financial consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest) : o f S tir a7- Lzoe ( 2 ;and/or [ ] e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : e F S eZ— The public interest that the personal interest conflicts with is described as follows: 3. I have attached additional detail on the reverse of this form or on attached sheets, including copies of all relevant documents , memos , resolutions, and contracts . $J& ArTAa-kle!j 4 . (Select one) [ ] I will not make or participate in the . making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: dr A42 ly 5 . I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief . 6. I hereby, certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the 17 day of t'R:,L 19 . i � Subscribed and sworn before me the day of 19CK, in County, Michigan Notary Public/or MARILYNN SLADE Deputy Clerk Notary Public,Ingham County,MI County, Michigan My Comm. Expires Mar. 18, 1999 My Commission Expires: 3 —l� FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: l —(-�—`1 !�— COPIES SENT TO: [ ] Mayor [ ) City Council President ( ] Department Head ( ] Board of Ethics DATE SENT: BY: �� Z`t '1�/ C-c)um cd cq�jot, 4 ti N SING OFFICE OF THE MAYOR 9th Floor,City Hall 124 West Michigan Avenue Lansing,Michigan 48933-1694 (517)483-4141 (Voice) (517)483-4479(TDD) (517)483-6066(FAX) C H I G David C. Hollister, Mayor On April 25, 1995 I will be sponsoring an annual birtGeneral party fundraiser. T Dickson,sultansr Minor and 1League llian Z baseball team Manager of the Springfieldearance of the baseball team at the offered, and I accepted, an app event. special consideration, no favors were asked, No money, no offer was a suggested or received. The goodwill and an opportunity for the team to see our city and the stadium site one year before they are scheduled to move to Lansing. A visit to Sparrow Hospital and a promotion of its Miracle Network Fundraiser is also scheduled that day. I will receive no direct or indirect personal financial benefit from the fundraiser. I file this Affidavit Of Disclosure to alleviate any concerns of a possible conflict of interest. 0. David C. Hollister Mayor "Equal Opportunity Employer" CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ ] CITY ATTORNEY and [ ) MAYOR and , DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) lbaJ'�O e . LL1 STD being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title) mPkW2_ in the Department. This position is: >] Fulltime [ ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) , a member of my immediate family as defined in Ordinance 290 . 02 (i ) , [ ] and/or (Name) a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c ) and (d) : (Select the option or options that apply) [ ] a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows : S E c �t-fA rn 6 tt_ The financial benefit will be received by the following persons in the following amounts: 7d£S K) nT 'q::M�('� ;and/or [ ] b. intend to have business dealings with the City of 1 Lansing, either directly or indirectly. The business dealings are specifically described in detail as follows ( include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest) : �60Es mar aA ply ;and/or [ ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows: The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly, is described as follows : 10ES Nor �� ; and/or [ ] d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings , the financial consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest) : o F.S NaT- 2 ;and/or [ ] e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : The public interest that the personal interest conflicts with is described as follows : 3. I have attached additional detail on the reverse of this form or on attached sheets, including copies of all relevant documents , memos , resolutions, and -contracts. $i,& ArT�L''+, 4 . (Select One) [ ] I will not make or participate in the . making of ,the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: 'hoes toOT- 842 YY 3 5. I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief. 6. I hereby.. certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the J:K day of At'2,L , 19 . e Subscribed and sworn before me the day of , 19q�", , in County, Michigan Notary Public/or MARILYNN SLADE r Deputy Clerk Notary Public, Ingham County,MI County, Michigan My Comm. Expires Mar. 18, 1999 My Commission Expires : FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: q —I-�—`"l !�— COPIES SENT TO: [ ] Mayor [ ] City Council President [ ) Department Head [ ] Board of Ethics DATE SENT: — [-7- q < Boar 4 BY: �' Z� 'rs/ c-c)urn CE e'v4d0�' 4 ti P S j �c OFFICE OF THE MAYOR 9th Floor,City Hall 124 West Michigan Avenue Lansing,Michigan 48933-1694 (517)483-4141 (Voice) (517)483-4479 JDD) (517)483-6066(FAX) CHIG David C. Hollister, Mayor on April 25, 1995 I will be sponsoring an annual birthday arty fundraiser. Tom Dickson, Owner Min Gillian iLeagueZ baseball teral eam p Sultans Manager of the Springfieldearance of the baseball team at the offered, and I accepted, an app event. No money, no special consideration, no favors were asked, suggested or received. The eam ofrto seewasaour expression ty and the goodwill and an opportunity forthe team stadium site one year before they are scheduled to move to Lansing. A visit to Sparrow Hospital and a promotion of its Miracle Network Fundraiser is also scheduled that day. I will receive no direct or indirect personal financial benefit from the fundraiser. I file this Affidavit Of Disclosure to alleviate any concerns of a possible conflict of interest. 1 David C. Hollister Mayor "Equal Opportunity Employer" CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ J CITY ATTORNEY and [ ] MAYOR and DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) lbao''A C . 4LIUS being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title)— ma-.[o2 in the Department. This position is: x Fulltime [ ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) a member of my immediate family as defined in Ordinance 290 . 02 ( i) , [ ] and/or (Name) a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c) and (d) : (Select the option or options that apply) [ ] a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows : The financial benefit will be received by the following persons in the following amounts: ;and/or [ ] b. intend to have business dealings with the City of 1 Lansing, either directly or indirectly. The business dealings are specifically described in detail as follows (include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest) : :IVES OOT- A, ;and/or [ ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows: The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly , is described as follows : 16£5 'raT- ?� pv Ali ;and/or ( J d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings , the financial consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest ) : 2 ;and/or [ ] e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : -i>e F.S of The public interest that the personal interest conflicts with is described as follows : 3. I have attached additional detail on the reverse of this form or on attached sheets, including copies of all relevant documents , memos , resolutions , and contracts . SZE_ ATT,4Q"-kIA�-0 4 . (Select One) [ ] I will not make or participate in the . making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: tjdr 64r � 3 5. I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief . 6. I hereby. certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the 1-7 day of L 19 . e Subscribed and sworn before me the day of 196K, in County, Michigan Notary Public/or MARILYNN SLADE IDeputy Clerk Notary Public,Ingham County,MI County, Michigan My Comm.Expires Mar, 18, 1999 My Commission Expires : FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: -I-� " -1 !�-. -- COPIES SENT TO: [ ) Mayor [ ] City Council President [ ) Department Head [ ] Board of Ethics DATE SENT: 4- [-7- q < /i B Y. �- 2`� '`1'' C�Ufy-)C c� c9eA 01-, 4 S I N OFFICE OF THE MAYOR 9th Floor,City Hall 124 West Michigan Avenue Lansing,Michigan 48933-1694 I (517)483-4141 (Voice) (517)483-4479 JDD) (517)483-6066(FAX) HI David C. Hollister, Mayor On April 25, 1995 I will be sponsoring an annual birthday eral arty fundraiser. Tom Dickson, caner Minor and iLeague llian Z baseball team p Sul Manager of the cSpringfieldan appearance of the baseball team at the offered, and I accepted, event. No money, no special consideration, no favors were asked, suggested or received. The the teameam rto see was aour expressionty and the goodwill and an opportunity stadium site one year before they are scheduled to move to Lansing. A visit to Sparrow Hospital and a promotion of its Miracle Network Fundraiser is also scheduled that day. I will receive no direct or indirect personal financial benefit from the fundraiser. I file this Affidavit Of Disclosure to alleviate any concerns of a possible conflict of interest. 1 David C. Hollister Mayor L///-7 /fS "Equal Opportunity Employer" CITY OF LANSING AFFIDAVIT OF DISCLOSURE OF CONFLICT OF INTEREST TO: [ ] CITY CLERK or [ ] CITY ATTORNEY and [ ] MAYOR and DEPARTMENT HEAD or [ ] CITY COUNCIL PRESIDENT (Name) lai.,O e 4L j STD being duly sworn, says under oath: 1. I am an elected or appointed officer or employee of the City of Lansing, holding the position of (Title) mP-1[o2 in the Department. This position is: x Fulltime [ ] Parttime ( less than 25 hours/wk) [ ] Unpaid. 2. [ ] I , [ ] and/or my (Relationship) a member of my immediate family as defined in Ordinance 290 . 02 ( i ) , [ ] and/or (Name) J)OL5 Aroma a business with which I am associated as defined in Ordinance 290 . 02 (b) , ( c ) and (d) : (Select the option or options that apply) [ ] a. may receive a financial benefit of more than a de minimus. nature which is distinguishable from the benefits to the person as a member of the public or as a member of a broad segment of the public from a decision I would otherwise make or participate in as an officer or employee. The decision involved is described as follows : The financial benefit will be received by the following persons in the following amounts: 7d ES '4 ;and/or [ ] b. intend to have business dealings with the City of 1 Lansing, either directly or indirectly. The business dealings are specifically described in detail as follows ( include names of each party, the duration of the dealings, the financial consideration between the parties, the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of dealings, and the nature of any pecuniary interest ) : I IoES AYO-r ;and/or [ ] C. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of Council action. The action involved is described as follows : The income or benefits , in addition to official remuneration, that will be derived, either directly or indirectly, is described as follows : £5 ticT- v ;and/or [ ] d. may derive income or benefits, either directly or indirectly, in addition to official remuneration, as a result of a contract with the City. The contract is specifically described in detail as follows ( include names of each party, the duration of the dealings , the financial. consideration between the parties , the governmental facilities or services involved, the nature and degree of assignment of government employees for fulfillment of the contract, and the nature of any pecuniary interest ) : o f S N aT` A-Ot?h( 2 ;and/or [ J e. have a conflict between a personal interest and the public interest as defined by state law, the Lansing City Charter, or ordinance. The personal interest that conflicts with the public interest is described as follows : S eZ- The public interest that the personal interest conflicts with is described as follows : 3. I have attached additional detail on the reverse of this form or on attached sheets , including copies of all relevant documents , memos, resolutions, and contracts . SiL Wr-TAcc-� 4 . (Select one) [ ] I will not make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, OR [ ] Despite the conflict of interest, I am able to make or participate in the making of the affected decision and/or governmental decisions concerning the contract and/or governmental decisions concerning the business dealings and/or governmental decisions concerning the conflict, fairly, objectively, and in the public interest because: A4 ly 5. I hereby certify that this disclosure is complete and accurate to the best of my knowledge, information and belief . 6. I hereby. certify that I have not solicited or entered into any agreement with the City of Lansing prior to filing this affidavit. The foregoing Affidavit of Disclosure of Conflict of Interest was executed on the 1-7 day of ya:t L 19 . e Subscribed and sworn before me the � � day of 196K, in County, Michigan Notary Public/or MARILYNN SLADE Deputy Clerk Notary Public, Ingham County,MI County, Michigan My Comm. Expires Mar.18, 1999 My Commission Expires : FOR CITY CLERK/CITY ATTORNEY USAGE DATE FILED: !�— COPIES SENT TO: [ ] Mayor [ ] City Council President [ ] Department Head [ J Board of Ethics DATE SENT: 4— 1-7- Q < 90a.r4 BY: 'r- " Z '�)� CO U/Yl Cj c9eA01" 4 ti h N S j N OFFICE OF THE MAYOR 9th Floor,City Hall \ 124 West Michigan Avenue Lansing,Michigan 48933-1694 (517)483-4141 (Voice) (517)483-4479 JDD) IjG0 (517)483-6066(FAX) H David C. Hollister, Mayor on April 25, 1995 I will be sponsoring an annual birthday party fundraiser. Tom Dickson, or Minor and 1Leaguellian Zucker baseballnteam manager of the Springfield sultans offered, and I accepted, an appearance of the baseball team at the event. s were No money, no special Then team coffer was tion, no f an rexpress on eof suggested or received. goodwill and an opportunity theyare scheduledteam to ee our city and to move to Lansinge y for the stadium site one year before A visit to Sparrow Hospital and a promotion of its Miracle Network Fundraiser is also scheduled that day. I will receive no direct or indirect personal financial benefit from the fundraiser. i file this Affidavit of Disclosure to alleviate any concerns of a possible conflict of interest. David C. Hollister Mayor L///-7/fS "Equal Opportunity Employer"