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i <br /> 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 /> I <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, Wesley S. Davis hereby disclose that on antPmh r 22 ,20 11 <br /> (a)A measure came or,will come before my agency which(check one) <br /> inured to my special private gain or loss; <br /> X inured to the special gain or loss of my business associate, Rick Baker was successful bidder <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 /> inured to the speciai gain or loss of ,which <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 /> i <br /> September 22, 2015 <br /> Date Filed Signature Wesley 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$10,000. <br /> CE FORM 8B-EFF.1/2000 PAGE 2 <br />