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R ) FORM 813 MEMORANDUM OF VOTING CONFLICT FOR COUNTY MUNICIPAL AND OTHER LOCAL PUBLIC OFFICERS LAST NAME - FIRST NAME-MIDDLE NAME NAME OF BOARD, COUNCIL. COMMISSION , AUTHORITY , OR COMMITTEE Davis Wesley Boa d of County Commissioners MAILING ADDRESS THE BOARD, COUNCIL, COMMISSION , AUTHORITY OR COMMITTEE ON WHICH I SERVE IS A UNIT OF: 27th Street Bldg . A ❑ CIN XINCOUNTY ❑ OTHER LOCAL AGENCY CITY COUNTY NAME OF POLITICAL SUBDIVISION: Vero Beach Indian River DATE ON WHICH VOTE OCCURRED MY POSITION IS: November 8 2011 >�X ELECTIVE ❑ APPOINTIVE 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 . 31439 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 mea- 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 OCCURS by completing and filing this form with the person responsible for recording the min- utes of the meeting, who should incorporate the form in the minutes . 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 r` G F(1RKA RR _ F: ;:;= i i9nno