HomeMy WebLinkAboutWarrenSue Affadavit Disclosure 2005 CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
Date:
To: City Clerk
City Attorney, or
Board of Ethics J
I J JE 1UA"'`-,:5;A' 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 or.0 employee of the City
of Lansing holding the position of Alavke-linp L3Aa aditst in the '
� -c soL)i P)o-iiii;,lc� ent.�41'vs i �DepartmV baavcC d 1l��f ►"-
❑ 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 at the Board of Water and
Light.
❑ 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. ❑ Fzr I may derive income or benefit directly from a contract with the City or
from any City action detailed below. (Charter 5-505.1)
❑ 1 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].
Pr ❑ 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 hours/wk) ❑ Unpaid
4. My address is: 73 0 e� &1 I v\S + l�-q . lk t E-
5. My Business (daytime) Phone#is:
51 - �U�-- (os�s�
Continued on page 2
-1 -
City of Lansing Affidavit of Disclosure
6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S)FOR SUBMITTING THIS DISCLOUSRE
AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST.
I don't believe this topic is considered a conflict, but to foster full
disclosure I am submitting this Affidavit of Disclosure.
Although I was not the final decisions maker, I was involved in the
purchasing decision for the BWL EnergyWise Weatherization Program
where Urban Options of East Lansing, Michigan was chosen as the
implementation contractor.
During my career over the past 20+ years in the energy field, I have
developed several personal relationships with other energy professionals
which include the Executive Director at Urban Options.
My participation in the selection of Urban Options was not influenced by
my relationship with the Executive Director, but rather by which
organization was the best qualified to deliver the Program objectives.
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 o15- day of(901'4/ya✓ , 20 06-
J, .-2tu-,k�,
nn Signed
State of Michigan, County of
Subscribed and sworn to before me this day f � �/
a�J of
< C. 20 U`
ROBIN RAYCHELL SORRELLS Notary Public Deputy Clerk
Notary Public,Ingham Co.,MI /"
My Comm.Expires April 17,2007 �/�f!/L� '�-z• County,Michigan
My Commission Expires: 7
DRAFT 5A REVISED 10-09-01
-2-
` From the 11-07-05 Council Meeting Packet
REFERRED TO THE CITY
' ATTORNEY AND REFERRED TO THE
ETHICS BOARD
CITY OF LANSING �
AFFIDAVIT OF DISCLOSURE
Date:
To: City Clerk
City Attorney, or -
Board of Ethics J
I 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 or 9 employee of the City
of Lansing holding the position of Marke-4»4 JPaaaitst in the
2LSOug-L✓Ma-n ni jL.,-_Department. s)N& board- d
❑ 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 at the Board of Water and
Light.
❑ j� 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. ❑ 1W I may derive income or benefit directly from a contract with the City or
from any City action detailed below. (Charter 5-505.1)
q 1 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(1) of the
Code of Ordinances].
❑ 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 hours/wk) ❑ Unpaid
4. My address is: 730 e. I cti e L&L) L-0-�\S l v\-q I t U
5. My Business(daytime) Phone#is:
Continued on page 2
-1 -
City of Lansing Affidavit of Disclosure
6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S)FOR SUBMITTING THIS DISCLOUSRE
AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST.
I don't believe this topic is considered a conflict, but to foster full
disclosure I am submitting this Affidavit of Disclosure.
Although I was not the final decisions maker, I was involved in the
purchasing decision for the BWL EnergyWise Weatherization Program
where Urban Options of East Lansing, Michigan was chosen as the
implementation contractor.
During my career over the past 20+years in the energy field, I have
developed several personal relationships with other energy professionals _
which include the Executive Director at Urban Options.
My participation in the selection of Urban Options was not influenced by
my relationship with the Executive Director, but rather by which
organization was the best qualified to deliver the Program objectives.
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 o2,5— day of('0 20 OS
Signed
State of Michigan, County of (�7da,12�
Subscribed and sworn to before me this C day of ��G 20 O /
-ROBIN RAYCHELL SORRELLS Notary Public Deputy Clerk
Notary Public,Ingham Co.,Mt
My Comm.Expires April 17,2007 �j fClii�z. County,Michigan
My Commission Expires: 7
DRAFT 5A REVISED 10-09-01
-2-