Fort Walton Beach Council minutes — 12-14-2010 regular — reading text

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 after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST Michael Holmes _ , December 14 , Zo10 I hereby disclose that on a) A measure came or will come before my agency which ( check one) 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 which r inured to the special gain or loss of 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: A Resolution of the City of Fort Walton Beach designating a brownfield area in the City ( Res. 2010 -42). I declare a conflict of interest as I am the beneficiary of a trust on property located at 16 Robinwood Drive, which is in the proposed brown field, and I abstain from the vote. December 14, 2010 Date Filed Si ature Michael Holmes NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES § 112.317, 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. EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $ 10, 000. CE FORM 86 - EFF. 112000 PAGE 2