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FORM 86 vMEMORANDUM OF VOTING CONFLICT . FOR COUNTY, MUNICIPAL , AND OTHER LOCAL cPUBLICIONs ROFFICERS NAME OF BOARD* COUNCILo ITY, OR COMMITTEE LAST NAME—FIRST NAME—MIDDLE NAME IRC Board of Count y Com I i Davis , Wesley S . THE BOARD, COUNCIL, COMMISSION , AUTHORITY OR COMMITTEE ON MAILING ADDRESSWHICH I SERVE IS A UNIT OF: 1801 27th Street , Builcting A ❑ oln 6000NTY ❑ OTHER LOCAL AGENCY -_ -CITY COUNTY -NAME-OF POLITICAL-SUBOIVISICN . Vero Beach . Indi n River DATE ON WHICH VOTE OCCURRED I MY POSITION IS: September 8 , 2009 & Se tember 22 2009 X� ELECTIVE ❑ APPOINTIVE � F a Y WHO MUST FILE FORM 813 This form is for use by any person serving at the county , city , or other local level of government on an appointed or elected board , council , commission , authority , or committee . It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112 . 3143 , Florida Statutes . Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position . For this reason , please pay close attention to the instructions on this form before completing the reverse side and filing the form . INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112 . 3143 , FLORIDA STATUTES A person holding elective or appointive county , municipal , or other local public office MUST ABSTAIN from voting on a measure which inures to his or her special private gain or loss . Each elected or appointed local officer also is prohibited from knowingly voting on a III sure which inures to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the parent organization or subsidiary of a corporate principal by which he or she is retained) ; to the special private gain or loss of a relative ; or to the special private gain or loss of a business associate . Commissioners of community redevelopment agencies under Sec. 163 . 356 or 163 . 357 , F . S . , and officers of independent special tax districts elected on a one-acre , one-vote basis are not prohibited from voting in that capacity . For purposes of this law, a " relative" includes only the officer' s father, mother, son , daughter, husband , wife , brother, sister, father-in-law , mother-in-law, son-in-law, and daughter-in-law. A "business associate" means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer, coowner of property , or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange) . } * * } } } ELECTED OFFICERS : In addition to abstaining from voting in the situations described above , you must disclose the conflict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting ; and WITHIN 15 DAYS AFTER THE VOTE OCCUR $ by completing and filing this form with the person responsible for recording the min- utes of the meoting ,. whq should - incorporate the.form in the minutes . Ir It It } } } APPOINTED OFFICERS : Although you must abstain from voting in the situations described above , you otherwise may participate in these matters . However, you must disclose the nature of the conflict before making any attempt to influence the decision , whether orally or in writing and whether made by you or at your direction . IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN : You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting , who will incorporate the form in the minutes . (Continued on other side ) PAGE 1 f` C Cl10 � 1 OD CCC � 10l�l1l1