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APPOINTED OFFICERS (continued) <br /> • A copy of the form must be provided immediately to the other members of the agency. <br /> • The form must be read publicly at the next meeting after the form is filed . <br /> IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: <br /> • You must disclose orally the nature of your conflict in the measure before participating. <br /> • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the <br /> meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the <br /> DISCLOSURE OF LOCAL OFFICER 'S INTEREST <br /> I, <br /> Wesley S Davis , hereby disclose that on December 4 , t20 07 <br /> (a) A measure came or will come before my agency which (check one) <br /> inured to my special private gain or loss; <br /> 7 inured to the special gain or loss of my business associate, Rick Baker —I <br /> _ inured to the special gain or loss of my relative, <br /> inured to the special gain or loss of by <br /> whom I am retained; or <br /> , which <br /> inured to the special gain or loss of <br /> is the parent organization or subsidiary of a principal which has retained me. <br /> (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: <br /> My business associate , Rick Baker is a 10% owner of the Oslo Commerce Center , L . P . <br /> December 4 , 2007 ' <br /> Date Filed Signature lesl ey S . Davis <br /> NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE <br /> CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING : IMPEACHMENT, <br /> REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A <br /> CIVIL PENALTY NOT TO EXCEED $109000. <br /> PAGE 2 <br /> CE FORM 85 - EFF. 1/2000 <br />