#124 Heriberto J. Sosa 11/10/2015 _ .. . . . -FORM 8B --ME VI-O-RA ND U NI-O F VOTING CON-FtIC T-FO R •
CO-U=NTY, ICUN-ICIPAL, AND-OTHER LOCAL PUBLIC OFFICERS•
LAST NA,F-FIRST NAME- IDLE NAME NAME OF BOARD,COUNCIL,COMMISSION,AUTHORITY.OR • AITTEE
MAILING ADDRESS )N �h THE BOARD.COUNCIL,COMMISSION,A THORITY OR COMMITTEE ON
p/ yr4, W�HIC�H�I SERVE IS A UNIT OF:
CITY COUNTY j°`Qi ❑COUNTY 7 OTHER.LOCAL AGENCY
d A) /IJ fute NAME OF POLITICAL'SUBDIVISION:
DATE-ON WHICH VOTE OCCURRED 1 J MY POSITION IS:
/Q 00,/0 ��j S 0 -ELECTIVE AP OINTIVE
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WHO MUST FILE-FORM 88
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• 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 Eesented"with a-iyotin
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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 grey t,°ly depending
on whether you hold an elective or appointive position. For this reason, please-pay-close attention to the instructionsron this form before
completing the reverse side and filing the form.
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INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143,-FLORIDA STATUTES
A person-holding elective or appointive county.municipal, or other local pub i.c 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
1:63.357,F.S., and officers of independent special tax.districts-elected on a one-acre, one-votebasis 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).
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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
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• 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'for-m in the minutes.
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APPOINTED OFFICER'S: I
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)
CE-FORM 8B--EFF. 1/2000 - PAGE 1
APPOINTED-OFFICERS (continued)
• A copy of the-form must be provided immediately to the other-members of-the-agency.
• The form must-be-read publicly at-the next meeting after the form is filed. -
IF YOU'MAKE-NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY-DISCUSSION-AT THE MEETING:
• You must disclose orally the nature of your conflict in the measure before participating.
- • 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
meeting, who must incorporate-The form in the minutes.A copy of the form must be-provided immediately-to•the other members of the
agency, and the-form must be read-publicly at-the next-meeting afterthe form is filed.
:OtSCbOS.URE OF L-OCA.L OfFI R'S INTEREST
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,-hereby disclose-that on -�/-V- b /� �� -20 :
a A measure came or will come before my agency which(check one)
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inured-to my special private gain or loss;
inured to-the special gain or loss-of my business associate,
inured-to the-special gain or-loss Of-my-relative, •
inured-to the-special gain or loss of , by
whom I am retained; or
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inured to the special gain or loss of f which
is the.parent organization or-subsidiary-of a principal which has retained me.
(b)The measure-before my agency and-the- nature of my conflicting interest in the measure is as follows:
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Date Filed / Signature
NOTICE: UNDER'PROVISIONS OF-FLORIDA STATUTES §11-2.317, A FAILURE TO MAKE ANY -REQUIRED-DISCLOSURE
CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT,
.REMOVAL-OR SUSPENSION FROM-OFFICE OR:EMP.L'OYM-ENT,-DEMOTION, REDUCTION IN SALARY,-R-EPRIMAND, OR A
:1 -CIVIL PENALTY NOT TO-EXCEED $10,000.
CE-FORM 8B--EFF.112000 PAGE 2