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Cemetery Board 5 MEMBERS AND 1 ALTERNATE Established per Ordinance No.241 City Clerk Four Regular Members with Three-year Staggered Terms One Alternate Member with a One-year Term 2015 CEMETERY BOARD MEMBER EXPIRES PHON '"Mt..;'= `` , OFESSION BONE, William 12/16 734-9199 % Ret. Engineer 804 SW 15th Street(33426) Appt'd 5/3/11 whbone►.�F�' a w--15;t.,., '4. r GLINSKI, Bonnie 12/15 733-,' .{ Ret. Deputy City 806 SW 15th Street(33426) Appt'd 9/4/07 Clerk PILE V.Jo 12 17 s ? Y / ,��� -u�' �= Retired Risk Mngr 1653 Palmland Drive (33436) Appt'd 5/5/15 '„ il.com _ F STINE, Claudia 12/17 ray 873 Teacher 2814 SW 4th Street(33435) Appt' < �„ �p stinec7575Ca bellsouth.net PRAINITO Janet-Secretas ' 1` •:, '<»� 742-6061 City Clerk ' }:..v "'" r prainitoj(a bbfl.us » A My ez ALTERNATES: OPEN < ''` 12/15 z .. J? s; — • ' CITY EM ���� $ ;r z NTATIVE: CHRIS ROBERTS—Assistant Director of Public Works .R�� ,•�..:iii M- Updated:8/31/2015 Sunset by Ordinance 15-018 on 8/18/2015 • . • . . . . • . ,3, ..• . . , • . • . • . . . . . . . . ORDI1OCE # 241 ,---, .• * . ;; • • • . • . , , . . .. 1 .. • • ;,<,,\. . .:'':•: . . . ; , ;•,0,..0104104, a•:917*,*(LlIgir pri-BozaTcp.:44 •nc:aa,*$, .• ' • •.: :i:. • -•• '• . 70,,tfM0 tiX6:::!Ititr13titialtlit;;!:ditAtzto:,.-11fit,.B.d (:jtvlititig . • . , ... .......• ..,.. ...• .,. • . ...,. ... .• ,.. ,s z,•e., .• ,. .. ,•. .:,•.. . . . AV ICO;0.;04P 4 1 2 AY;lr ':nQt;;O:0:A*: Bek ..1..,T:.-'0,0•0'.t061:5i•' • „.:tx.04A4t0.40:1:6#1001***:.;040:iiMirit01 ;,.1*. gord.• . . . :......'s • .ALL co.#0101740::•;90t40.00.',111t*ttUla...tv.#161,aPA' !OR: , • • Itoldskilte•vilptvort. • . . • Ea• IT.:4101,4323D .37 TBE:011Er Oommisszolt or-tits cirz•dr . • . ••:.••;:, .. . .: :::::d:L . • : lit'i'--i• :41)4%4; 740•43).4.. - • -1 . . . . .. . •,.:•i• •. . . . • .. . . '',;', L., • • . • . :sotto*. It _ That thefollowing described..real estate,.belie, ' . • ' • " - ' • • ,,, .• ',.:1;',:i::,.. • - • the :DIvia(*te .of. the.•City: of ii.eynton,..13e0h$:,:sit4ate, 1„.-ei24, e4o.°. being Lu . • . . .•••.;,d.' •• • . . .. . -44.:•::;h, ; . •the. City of Botraton Beach in the. County of Palm-Beach eaul State .of • . • . .1.4,';'R • . : .•;1,,. • :;:pl:i:. • ' - 7.1oridai more Vartidi4p5173.27 :.116,170r60.•.4Z. follows, to-4t$ :,i;',. .. • ••: . -t . , . „,; . • • East;--4OO.•feet :of. Lo 5, less.tbe. so.p.-th 1.50 • . . . . . .: . . . .. . .. . . . .:,. f00:-:thereof, ;an4: taxe....ve.,4.-ppti.dc0...of lot I, . . .0.4, •. .: : . " less the sots 150 feet thereof,•;lying. west • ..., :;,::.r---! •:: . - . . -: :or the Oreen;•.$:.treet':opitinnatiOn. right''of way .'.:.:j' ! . . -.. - • . in, Section.331; •To ship ../.6. pott.b, ,.Range 4.3 . . • •:-:1 ......i ::.11e;st;• tea.00rAng••to the plat thereof:reOV.rdeit )+2-• . . •'1.'f-•i'. '• • .' - .. ..-.... '.. 4 .• • • th-6..offleet:'ef'..the: °leek.Of. Circuit tort.in . . • . . 4,`,;,:'i-::: • . . •. . . . , aa i4-i;oi:ttiTi;173301i.t.O.Oittiri -F1oill14C••'IA. •iii4: :•• . .• • • - • . . .• ''"''''' .. •• • be ;a4(1:the sill* is hereby set ;aside and eetablis.hed. as a. pe.nete7, to:be . . ;its.fslt v; - • )it ia• , • '1*Owli.aiiii.d4tioatoi.akOoynto7n. oh-/traniciyal 9.ataetarYi •and that the • ;q;;;'.,l'I.: •• • • . • •• . • • .. ' :--`• ci7 •f'. ..1 k: r )1'.-k. . r: r. 't :I. '4.: ",.-7 • • -: - • . ' . ;• '. • . ;1P '.1:' .' - • .pie,t''.of i a. portion.thereof.:filed in the office of !...ktie Vie* of.Circuit .'•:Court or•Peap ,Bezipit:Oe*.tn. 71prida„ i.tc..Plat ?3,0e1 21, "page 84,, winch: is . . • - . -:;;:-,,..• . . e;."part•:Of the 'above clesdriptio32,• 844. iehereby-a3a-0.gtat.ed_•as an 'official . .. ;,;,: .: • . .4 ;itih.;f- , •• 12!;(.f4;f. • • • S.• plat; for.; the grenondo for:::.oenstary..;, . 'oo:oog ;;. ;....:. .:,. ; .•.;• .. • .;. . . WN...: ,..t.=,,,.: -Sat44)1,al The ..City Commission: shall,from time to time by •. - :• • resoIntiOn, -irevide-fOil the sale of said:lots, filt!the:.priee to be charged.. 'therefor, and.theterrae..and. bond itions.s,9f such sales, aria previde..for the • . i,n..f• :_.. .c.,. W:il t • ' :ni'.:.i .- •. 'eehvt,,yanee' of such :ots,;-. ant shall fix:the schednle of•fees to:be charged; :•?•'.:!. 1, ..., .. ;•:( r• • • . ' . .:- for permits, burials, Oat other services*..• , . - .• ,. . - .•;1.1;1:;-;:‘; • . - '. . • •; • . ,...;"•4 • , , '. • • • . !..t'ie., : , . . . . . . • .r!•:tM • • ' • • t • • " . . 0. . .. . 14.4.. •• .•. ••• . . . . . .• • •. . . . • •.?..ON qfj. :' :;•• .' . . • ' • ' • . . . • ::::••'. ' . ."" "" " . •: • . : . _ ' ' . . .. .:. . . , ;.!,.1h :..; • . . . . . • ..,:.:. •.? • - . t ' . - ... „ . . .. . , . . . . . . • ,..---, ' . . • . . • ', __ I . . . . . • ' . . . . . . • . . . . . . Section 31 37•.o let s111 be-used. for .anY purpose other than ' . • • - 1 , . ' as.4•.piace.:.of buriaL for.white.: dm**.onky., . . . . . •Section-4.1 The•owner or owners of• lots shell riot.allow 'interments- • .• mad.e• in their taid--.lots•for remuneration, nor.shall:err:.transfer*. assignment* • . or eonveyance of•anyllot to• awned* or of. erg' 'interest therein,..be, valid..without . . .. ••.,.-... : ,- . .• the.,otS4er:thereof',first"„havin.•••secared..the-written.Consent of the City * • • .• . .t....: : . . . . . .‘ . • ••...i:•!•,:, *. • . COTA7030tion,te.,,.make •Suult.trk;Inefer„.•,.assigto3.enti. or•otinveyace, •and. such .. • ;,.„,,., • • • :Wx.ittes.•:-,conSont'•39U3t: be:-endorsed..von such transfer* ateSiOment, or can.. :;:'A-• • • . YeYEMOOV...Frevided* hoWever,i. that no..t.ianifer*, asSigranent, Or :c47qtreYs!ao.e. .;;;:,..:. • i••':-•'' • - . of:May .10t,er•of...:any interest'therein can .'be..10.4: after. an•actiutl intervent • • . -..:..,z! - . •.•;•;;;;;: •411-1 . . in. it... e.lccept-with•"•'th,S Consent of the City Commission, and:the City * • . • , • n if.....'g•:::: • • . !?1.•••Acs, .. Corasission:,:./4a1MOt:.giaait- sUch.consent•until after the,body or,bodies first ;,.!•1.::';•1,-; therein :interred.,shall be•:.lawfully removed. therefrom;-ad.provide& farther . . •,J..,..•t•ir._)• .• that no-0.41Sinterment•shall.be allowed_except:by the consent of•the, City. n • , •...,...: . •• . .,.: . . :4'.:.::.; • Commission,:•and.farther with the•wri.ttch.'consent or order of the. owner or • .f.N.:: • - • .014;:00.•of...•..the,lot;:in:•stuestionf and provided.further that easy,lextru13.y:•con.:; - . .• l'..',1H . • 'MI ,: , • - . : • atitatted..attborit* .alagv:.•with.proper order from the Circuit Court of Palm • * n ,'fi''0:i ; , . . • Beach County, Florida*.disinter am...body so.buried. in• said. comets/7 'for ',.1,,-,• -• -{c11.1 •• i:.ill:; •., •• the: purpose of luvestigating..oriMak. .n. • . . . . :-.( .* .... - • • , ' : •• Section ..54• The. City Commission, through the Board. of 0Over3aors he;.04,14.*di:ova Vet, .in:justice to the •integost. of.the thole, reserves Lli,.., n , to itself,the right -of..preventine.the-removal or the right to .remove any • • . .*•,..i.:i',., • 'erection* .,eneleStre.....•;...monutienti. inscriptions. tree or shrub' which it.shall • . . •••. ... , • . ... • .. . . . . . . . . . Eir•!1 • . ' •. •••* aolleicler,:initOiplis.16,,*:the. 1:417a0:iate.-localitr or Trail01.Mal to the general i. i-;I; • • • • * . . lf,...i:;,„„., • .:•: , .•good.aopearsoice of the•grounds. '*•..: . . • .:•.:1!e• . * . . • •..„ , -.. •,,,k , • . . . , • • •• .• . . ,-1,,,,:'. .•;--...' . . . .:-.gi•i:i • 1::• . • • . . 41 ii:1:!• .: • . :• , : • . ,.. .2 .: • . , • . . • . ,...,,liti.n.:. .. - . .:. :. • .: •• • • : .1 .. . • . •1,'„,!•••.. • ' • . . • . . . • . •. . • . . . . . . • . . . . ..• .. . . .. . . . ._ . . . . . • • . , . . . - • -;''..,.. .. . . . • • . . . , . 6i. 43.3.:.lot enclosuresof any .1cind., :whatever are hereby 1:y2.6hibied....--.GCrner;iostOnes'properly,refitaboreil..-aod...•set.flush. xirith the. . • . , . strface..of the ettietrad: .s.1143;be allowed* No brielwOrk.shall be:allowed. . . „•••..... ". • aboVe. the.,gicilind.:.liri"eI in'any.-roortion.of.the cenietary. Nomounds •are . . . . .. . permitt0.4.":.Over,any..:.•graVe .or graves.. The•grade Of .',all.lots shall-be . j, --: •,;• : ' , " . board. create‘ •..A. space of.not.. • , . ,,. ..., . Ys:....- • .. . . 1055 tlii4ei.03-' ibea -(1 ) ii0Les:, shell be reserve&, on sides of E:hutting...Teti.' ..,.. - • .so....that tha.::isravos_.:ilaa4 not be.Contigneris*. ::411..workeen. employed..in the otinttitotl.to.•of-Vaults„::erection of moments, •or other work,;. shall be-,. •• . ' . ' :.....:... • . .....„. ,'•-.::'i;:. , : sehjeet to and.,under.•the..control:azaii direction of .said.Board. of Governors. , •' ..: .„ • '...:i.:'. - :".• • • .. ' ' : -, s.t*' Section 7. ,Is.41 moneyor other compensation; shall.be paid: .tsi.-• • • .•;.-1,.,j • artY.,:i)erson in the -.employ-of••i421.4 el:4y for personal. services• or',attention. . ...: •;:': ;•.,:;.,, 1 . : . . .. i ,. . . : ...'. . . , . .., . . . . . i '' . • •i .t i. :: . • opaer•than,tie-s alarios•and_wages paid by,..th.e..-Olty. : . . • • • :. . . '. •.: • .. .; . • • .• ' '''' . -•Setitin:.7a.". .e It sheal.be the of the.Board of Governors, to. . . •:!..1 :• • : ..appoint-.0..svervisor•or .soxtoxi... awl as4sta)Ats. as the .salie::pay-.be..necessary -. .'!il:;:' • . • . and.•:tiai.lhe..ealex7.or wage . o.-be .receivpd. by such. person or:persons. • ' . . : . -:..,:',,i1;;,i . . • . ' • . •,..'1.2,..', • * '.' ' . . Section 8*.., .Mo :protect „the...we:v*4s herein:described, and . . • . . • •Uieoecially to rirtiteoil-•..the•-itiprovect.pOrtionsa.114.,lots therein froe, injury,. .. , • •1:,!i ,.. , : . :;,lT.:;.1' , . • : • . , . .. ,..., • '10' • " all•excavaticons: shall.be made..by:the.City at the:,e0ense .of: the owners, . . -,:-cri-• ,, Under the -NriStitotp* a#13. control of the-Board.. of Governors* : :,•iii.,,.:;. . . i'dr;. '. • ' ' .'* ' Siat4On. .0.•, • It .o!ner- may.place•head.stone on said.burial plot. • •'''''• : but`.•all Said headst.orees:•.anlifor...mcnumentL s..tta,11..be.flush-with .the growidi .. . . . Ito maii..1%,..46.11-bo.:-,:4.41.-1-i without: the permission in writing of. the Board iii.P: ' . . • of.'.001enri4lriii1.-44- 04.:2c10t ,.,flof....-Nics03*:above ground..shall:be.of.-marble, 114,---,. : ' . • • granite cut stone,-:or oo:segt.':•)3.tOAO.or.bloCkS; . end..in any event'slit611 . . . •• • : . . 5 . . . . . . . . . . ...1111;••.; • •• . . • - • • • . . . . 11 lir'ci.];',.t • . • . . . . . . • . •• • . . .• • . • . . .. . • . • Ailli',i.::.:,:: • . - . • . • . ..' I. ....: .!. . ..: i : - 7-3.iii. ,•: :... . , ... '' • ' . . . . . . . . • .. •• • . . . . . . . . . . . __ • .• . . . . . . c • • . . . . . . - ' . • " ( ', . . . . . . . . r• .? . . be-of suoh• stretickh, construetion* encl.:.obweeeter :as may‘be appOolted.:by. the Board, of Governors..,• :All• earth.or. rubbisk••-eneumUlated:by• the owner:or owners • . • ..: ' - , ofa lot or.lots lir .otker. omen -must:be carefuLly reme ved•as..sonn as- possible and. d.ePosited:at such...place:as the Board. of governorsmay direct. . • • '. - • 2 Section l0.:!. No '5i : or Other..device indicating that' a lot or , '- • . ..., . :'',.•••:.. . . ' • vaul't te.:-:.erern.Selelf,-:.ifiail..10,-:pertittetkoin or on the_gionnds-above described. .. . ':••••,... . - , . .. • • 'f ..,. . . . • - Section 11. The....13parA.Of. Governors hereinaftercreated.,may. from , • , '.7,.... ' • time to time lay s:out, •alter, or ClOSe..1tuch:avenues*: drives, ,•or•walks* and ,,;;; - • . ... .1-;'„'•! . . • make such rules and:regulations for the governMent.,and;improvement of- the . ,... .... . . ,- . . .i'f,:; ': • ',Pi"• * . cemetery as theymay. deezi:requi.site •and. proper in order:to.,secure,and. . . . ,.....- `i'-.4':-• . . . . promote its general,objects and. benefits. : . , . , - . . • ., . • ...... t•F•!,..• • „,.. '. • •- ' ...Sqqtni*12.- No purchaser 711;),.13. be entitled, to a:' deed to any . . . .. lot all::.'•,eteeountS.relating..thereto and. due the. city are :paid.and•no 1 .. •;.n,i!. : owner•or.proprietor of any loty or lots..shall have the right. to• bury in P.,.1.:;:•.• ... , ' 1.0i.. ; .• .. 'his::said: lot 027'..1074*•Without•first having paid. any, and all zwrea.TEAges• dim. . .. . Iffi•.i.' z.. 111;'.. ,;'..• • . the city therefor or for .anything relating .thereto. ii..:.t,i:,:f.::. • . . . - • .. • goOiOxi,..).3.: Owners 'of lots shall be-• reet,/ired. to keep°.the same... .. •.,-.: . . • ),;',1,';. •;;; . . . sit!..,goed...'donditi4n. ..NO person•other thanthe owner himself. and. employees.. .nt'Vr., • i;O: :-',, . . . • of'.::the:. ElzOttiliti..':!1014a1.1.'.be:*,Ow.ed_••••to,.perform. any vox*,on a•lot without a :nr':. ' , . ' '• .: ' I,-, ' .permit'.fret':the Board. of .GOVernors.and.:all persons.so employed, shall be '..1'..,:!,41,. ;;;, - • . ... i''.,t•:-. . milder:.-the,.bonii001.'and..supervision.of-the Board of-Governors.: I . . • . . . .'.. :, * ' • Section The t7ie.. .eard. of Governors Shall notify the owner , • . • n . ' ! or 'Owners•Of tegl.eoted:lots:Of!the .condition of suchl.ot or lots, and., in. : 40,'...• ' .• . . ease .of continned.•:neglect :se that in the•'opinionof the,Board•of Governors ill!.'•! .4C:',.... • ..,,, . • . . • - • Yir:::::-,,'•'-‘, .....'" . • .. .the;general. -goeil..,appearanees..Of,•til* .cemetery is s:impaire4 such lot or•lets.*. 4- 1 • •-:. - n:1.1 ...' ' i • .i• . ! • keg.-be.-.dat. in•order an_i good condition,at •the expense:of •the.owners•thereof. T.,..,,:... .. • •••A:-.. ,.• • 11:-.f..::.:. :-. ' .. • . . . . . . .. • . !It',,:r.,f.• : . ..- :. - ,- •.. . . .. . . . i•,iti'H *- ' . ' • . • . - . . s. . *' n .:: ' n. . 4 . ,:::: . " ..s. •• ‘. . wil.. i• . • . . ili... -. ••, . . . . . . . .. . . . . . . . . . . Sect a.on:]:5. A7:1.•ferias rain: the sale of•lots 'wad all revenues l • ant•fees callecte'c ••iz .'aonnectiem•with the.'operation of the•'cemet:&ry, s r1•'►7. be' set aside. in•a:separate •fund:•'to •be designated as the "femetary •PUad , - ' .and. used. for, the.•perpetvaL care:.,upkeep; and maintenance. of said.•cemetary;. b +,t• such fund•from tine.to time; as accumulations.:are in jaagment of •the. City: Commission•sufficient,:-:meq:be_:invested in. ted. States Government * . ' • • • i" Seo ^i.ti.es.- . . • •• .. Section,ld. here..is hereby'created �d..established.`a Beard of - • Covers consisting of •thea:Clerk-.of the City•of,Boynton Beach, .and.five:other: ' f f,.. •. ' ' . pertensa.who 7'shall::be,:named.•by. the. Commissioners.of:said City; and. one such. • .,,(, • ether.person shall' serve for a..period. of one Year.from •the date of .appoint _,:t nista; two. for a,:period of tiro•years-from the idate..of appoimtmeut, end' there:;.,:*.' ' • : after. such::vacanaies ;shall:be filled by reappointment. or by' appointing some ,`'11:. ._' other person;for the:period:of three full years. members' of such Board. - • :!-fj:. • • • i: . ••e f 'Governors shall'have`the:right to.'stabil.eh.rules•as d.:reguilations for the' ;:.,;•. • ' m gement-and.. control.of said. cemevary, •axnd for, the oondnet• of tete Board.ts ,- •bmsinees, notinoonsi stent,-however, with the..p rovi•sions. of WO, ordiaaaice; ;(,Vii. f;a) :M.. . .. and.. • in addition.thereto• shall. comply.With, abide''by, .and'enforce the..provisions t:,,,: •and, .conditions•of...this_ordtnanee. Provideed, •however, that the Board• shall have :h.s no right,••power, or'•an thor'ity.to contract for the expenditures, .or. to expend.. $ii * • any moner.:eXcept. insofar as permission to do so shall be 'meted by motion 1.1'.4,'.4: tj. :, or resolution •of• the ,•Qiti' Corm�is:si.On.• ' . . `:The Clerk;of said. City 'shall. continue.:eo serve on .said.Beard, so . ' . t-.. i • • •- long: as he :shall.r ewk1t Clet.* :a s ,:.:sba].l:have all•:the•powers of•say other 4.1I • t;;. 'ember ,of saidBoard; and in::addi rtheretv shall.act:,as* Clerk thereof. . !-I;. It, is furtxber provided:�tht. the said. Board shall peep. an,.mate '. . Ill :-''.:':',. -reco• rd.of• all receipts.`and.•expenditur• es,. and••shall. fry time to time, as , . j :.;-•'• : •• • • . • , ••' •••• ••••••••, ..:• • .i'., '• .•'••. 1-.1,. • ..• :•• ••0.'.'s;•.: • ; - :••.•,••••:•;'•••.'....!.:••::, H.."...• :•.'. ....'• .. •••.: ' 2.••-•: . • ' -'I '11.1!):;1, • • • '.• ......atom& -.:.tat'''4' •:i' '.;- •••' : .* • • • : l'el' .. '''''':': •• 1 r:,IC,4,1 • , ... • '01,90.101,.-,./ ,'. .:::..re ",'..'07T4','. .. 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COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME-FIRST NAME-MIDDLE NAME NAME OF BOARD,COUNCIL,COMMISSION,AUTHORITY,OR COMMITTEE MAILING ADDRESS THE BOARD,COUNCIL,COMMISSION,AUTHORITY OR COMMITTEE ON WHICH I SERVE ISA UNIT OF: CITY COUNTY ❑CIN 0 COUNTY DOTHER LOCAL AGENCY NAME OF POLITICAL SUBDIVISION: DATE ON WHICH VOTE OCCURRED MY POSITION IS: 0 ELECTIVE ❑ APPOINTIVE • WHO MUST FILE FORM 8B • 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 112.31.43, 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 whomhe 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 inthe 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) 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 publiclyat the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST I, , hereby disclose that on , 20 • (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 inured to the special gain or loss of • ,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: • • • Date Filed Signature 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 8B-EFF.1/2000 PAGE 2 Section 2.443 (c) Disclosure of voting conflicts. County and municipal officials as applicable shall abstain from voting and not participate in any matter that will result in a special financial benefit as set forth in subsections (a)(1) through (7) above. The official shall publicly disclose the nature of the conflict and when abstaining from the vote, shall complete and file a State of Florida Commission on Ethics Conflict Form 8B pursuant to the requirements of Florida Statutes, §112.3143. Simultaneously with filing Form 8B, the official shall submit a copy of the completed form to the county commission on ethics. Officials who abstain and disclose a voting conflict as set forth herein, shall not be in violation of subsection (a), provided the official does not otherwise use his or her office to take or fail to take any action, or influence others to take or fail to take any action, in any other manner which he or she knows or should know with the exercise of reasonable care will result in a special financial benefit, not shared with similarly situated members of the general public, as set forth in subsections (a)(1) through (7). To search the database to see if a form is on file with our office, please follow this link http://www.palmbeachcountyethics.com/coepubNoteConflictNoteConflictSearch.aspx Memorandum of Voting Conflict for County, Municipal and other Local Public Officers (Form 8B) ! WHO FILES WHEN FILED I WHERE FILED County, municipal, or other Within 15 days after vote With person responsible for local public officers occurs recording minutes of meeting Additional requirements for H1Within 15 days after With person responsible for appointed public officers (see "participating" in matter recording minutes of meeting Section 112.3143(4), F.S.)