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8A 1 V • <br /> dojo - may/ <br /> FORM 813 MEMORANDUM OF VOTING CONFLICT FOR <br /> COUNTY, MUNICIPAL , AND OTHER LOCAL PUBLIC OFFICERS <br /> LAST NAME-FIRST NAME-MIDDLE NAME NAME OF BOARD , COUNCIL , COMMISSION , AUTHORITY , OR COMMITTEE <br /> Davis Wesley S *. Board of County Commissioners <br /> MAILING ADDRESS THE BOARD, COUNCIL , COMMISSION , AUTHORITY OR COMMITTEE ON <br /> 1R01 27th Strppt , Building A WHICH I SERVE IS A UNIT OF : <br /> CITY COUNTY ❑ CITY rX COUNTY ❑ OTHER LOCAL AGENCY <br /> Vero Beach Indian River NAME OF POLITICAL SUBDIVISION : <br /> DATE ON WHICH VOTE OCCURRED MY POSITION IS: <br /> October 5 2010 X ELECTIVE ❑ APPOINTIVE <br /> WHO MUST FILE FORM 813 <br /> This form is for use by any person serving at the county , city , or other local level of government on an appointed or elected <br /> board , council , <br /> commission , authority , or committee . It applies equally to members of advisory and non -advisory bodies who are presented with <br /> a voting <br /> conflict of interest under Section 112 . 3143 , Florida Statutes . <br /> Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly <br /> depending <br /> on whether you hold an elective or appointive position . For this reason , please pay close attention to the instructions on <br /> this form before <br /> completing the reverse side and filing the form . <br /> INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112 . 3143 , FLORIDA STATUTES <br /> A person holding elective or appointive county , municipal , or other local public office MUST ABSTAIN from voting on a measure <br /> which <br /> inures to his or her special private gain or loss . Each elected or appointed local officer also is prohibited from knowingly <br />voting on a mea- <br /> sure which inures to the special gain or loss of a principal ( other than a government agency ) by whom he or she is retained <br /> ( including the <br /> parent organization or subsidiary of a corporate principal by which he or she is retained ) ; to the special private gain or loss of <br /> a relative ; or <br /> to the special private gain or loss of a business associate . Commissioners of community redevelopment agencies under Sec. 163 . 356 <br /> or <br /> 163 . 3571 F . S . , and officers of independent special tax districts elected on a one-acre , one-vote basis are not prohibited from <br /> voting in that <br /> capacity . <br /> For purposes of this law , a " relative" includes only the officer' s father, mother, son , daughter, husband , wife , brother, <br />sister, father-in -law , <br /> mother- in-law, son -in -law, and daughter-in -law. A " business associate" means any person or entity engaged in or carrying on <br />a business <br /> enterprise with the officer as a partner, joint venturer, . coowner of property , or corporate shareholder (where the shares of the <br />corporation <br /> are not listed on any national or regional stock exchange) . <br /> ELECTED OFFICERS : <br /> In addition to abstaining from voting in the situations described above , you must disclose the conflict: <br /> PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you <br /> are abstaining from voting ; and <br /> WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the min - <br /> utes of the meeting , who should incorporate the form in the minutes . <br /> APPOINTED OFFICERS : <br /> Although you must abstain from voting in the situations described above , you otherwise may participate in these matters . <br /> However, you <br /> must disclose the nature of the conflict before making any attempt to influence the decision , whether orally or in writing and whether <br /> made <br /> by you or at your direction . <br /> IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE <br /> TAKEN : <br /> • You must complete and file this form ( before making any attempt to influence the decision ) with the person responsible for recording <br /> the <br /> minutes of the meeting , who will incorporate the form in the minutes . (Continued on other side ) <br /> CE FORM 8B - EFF . 1 /2000 PAGE 1 <br />