HomeMy WebLinkAboutSalimNadim Affidavit Disclosure 2005 CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
Date: May 27, 2005
To: City-Clerk—
City Attorney, or
Board of Ethics
I Nadim Salim 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. ❑ 1 am an ❑ elected or❑ appointed ❑ officer orXemployee of the City
of Lansing holding the position of Stock Distribution Specialist for the
Board of Water& Light Department.
❑ I 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.
❑ QI. 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. L ❑ 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].
❑ 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(1) of the
Code of Ordinances].
b( ❑ 1 make this disclosure because of a possible appearance that I may be
in violation of or in conflict with the City of Lansing Ethics Ordinances
as provided for in the Code or Ordinances and in the City Charter.
3, This position is: ❑ Full time ❑ Part time (less than 25 hourslwk) ❑ Unpaid
4. My address is:1730 Lindy Drive
5. My Business (daytime) Phone# is:517-323-3143
CONTINUED ON PAGE 2
6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S) FOR SUBMITTING THIS DISCLOUSRE
AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST.
I am a warehouse employee at the BWL. My wife is a wholesaler of angle brackets and
would like to sell them to the BWL. These brackets are received, stored and dispersed through
my department. I do not have any part in purchasing installing or evaluating these items.
I want to disclose this relationship to be sure I am not violating the City of Lansing's
ethics policy.
I herby 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 2-b dayo , 20
State of Michigan, County of
Subscribed and sworn to before me this -day of
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DRAFT 5A REVIESED 10-09-01