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<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 /> Board of County Commissioners
<br /> MAILING ADDRESS THE BOARD, COUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON
<br /> 730 Painted Bunting Lane WHICH I SERVE IS A UNIT OF:
<br /> CITY COUNTY ❑ CITY )I COUNTY ❑ OTHER LOCAL AGENCY
<br /> Vero Beach Indian River NAME OF POLITICAL SUBDIVISION:
<br /> DATE ON WHICH VOTE OCCURRED MY POSITION IS :
<br /> October 18 , 2011 ij 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
<br />or elected board , council ,
<br /> commission , authority , or committee . It applies equally to members of advisory and non-advisory bodies who are presented
<br /> with 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
<br /> greatly depending
<br /> on whether you hold an elective or appointive position . For this reason , please pay close attention to the instructions
<br /> on 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
<br /> a measure which
<br /> inures to his or her special private gain or loss . Each elected or appointed local officer also is prohibited from
<br /> knowingly 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
<br />is retained ( including the
<br /> parent organization or subsidiary of a corporate principal by which he or she is retained ) , to the special private gain
<br /> or loss of a relative ; or
<br /> to the special private gain or loss of a business associate . Commissioners of community redevelopment agencies under Sec.
<br /> 163 . 356 or
<br /> 163 . 357 , F . S . , and officers of independent special tax districts elected on a one-acre , one-vote basis are not prohibited
<br /> from voting in that
<br /> capacity .
<br /> For purposes of this law, a " relative" includes only the 'officer' s father, mother-, son , daughter, husband , wife ,
<br /> brother, 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
<br /> the 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
<br /> 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
<br /> and whether 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
<br /> recording the
<br /> minutes of the meeting , who will incorporate the form in the minutes . ( Continued on other side )
<br /> CE FORM 88 - EFF . 1 /2000 PAGE 1
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