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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 /> 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 /> 1,_ Wesley S. Davis , hereby disclose that on March 3, ,2019 <br /> (a)A measure came or will come before my agency which(check one) <br /> inured to my special private gain or loss; <br /> inured to the special gain or loss of my business associate, <br /> inured to the special gain or loss of my relative, brother, Brian Davis <br /> inured to the special gain or loss of by <br /> whom I am retained;or <br /> inured to the special 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 /> Relative Brian Davis, brother, owns and operates a business and may or may not benefit <br /> from the decision. <br /> March 3, 2015 <br /> Date Filed Signature �Wes4y7 .' <br /> 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 /> PAGE 2 <br /> CE FORM 813-EFF.1/2000 <br />