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Home My WebLink About2022 03 07 Foreman, Mike - COI for Reporter News Agenda ItemLOCAL GOVERNMENT OFFICER CONFLICTS FORM CIS DISCLOSURE STATEMENT (Instructions for completing and filing this form are provided on the next page.) This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY This is the notice to the appropriate local governmental entity that the following local government officer has become aware of facts that require the officer to file this statement in accordance with Chapter 176, Local Government Code. Date Receiv d 0�^ vim} 1 Name of Local Government Officer Mike Foreman 2 Office Held Mayor 3 Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code Reporter News 4 Description of the nature and extent of each employment or other business relationship and each family relationship with vendor named in item 3. The owner of the Reporter News is my son, Jim Foreman. 5 List gifts accepted by the local government officer and any family member, if aggregate value of the gifts accepted from vendor named in item 3 exceeds $100 during the 12-month period described by Section 176.003(a)(2)(B). Date Gift Accepted N/A Description of Gift N/A Date Gift Accepted N/A Description of Gift N/A Date Gift Accepted N/A Description of Gift N/A (attach additional forms as necessary) 6 SIGNATURE I swear under penalty of perjury that the above statement is true and correct. I acknowledge that the disclosure applies to each family member (as defined by Section 176.001(2), Local Government Code) of this local government officer. I also acknowledge that this statement covers the 12- o h eriod escribed by Section 176.003(a)(2)(B), Local Government Code.` nat e f Local overnment Officer Please complete either ption be w: (1) Affidavi ��s � �, LETICIA C BRYSCH " COMM EXPIRES 12-04.2022 NOTARY ID 12593027.0 NOTARY S /SEAL Sworn to and subscribed before me by Mike Foreman this the 7th day of March 2ql 22 Allywhich, witness my hand and seal of office. Leticia Brysch City Secretary Signature of officer adm' ist ring oath Printed name of officer administering oath Title of officer administering oath • (2) Unswom Declaration My name is and my date of birth is My address is (street) (city) (state) (zip code) (country) Executed in County, State of on the day of .20 (month) (year) Signature of Local Government Officer (Declarant) Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 LOCAL GOVERNMENT OFFICER CONFLICTS DISCLOSURE STATEMENT Section 176.003 of the Local Government Code requires certain local government officers to file this form. A 'local government officer" is defined as a member of the governing body of a local governmental entity; a director, superintendent, administrator, president, or other person designated as the executive officer of a local governmental entity; or an agent of a local governmental entity who exercises discretion in the planning, recommending, selecting, or contracting of a vendor. This form is required to be filed with the records administrator of the local governmental entity not later than 5 p.m. on the seventh business day after the date on which the officer becomes aware of the facts that require the filing of this statement. A local government officer commits an offense if the officer knowingly violates Section 176.003, Local Government Code. An offense under this section is a misdemeanor. Refer to chapter 176 of the Local Government Code for detailed information regarding the requirement to file this form. INSTRUCTIONS FOR COMPLETING THIS FORM The following numbers correspond to the numbered boxes on the other side. 1. Name of Local Government Officer. Enter the name of the local government officer filing this statement. 2. Office Held. Enter the name of the office held by the local government officer filing this statement. 3. Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code. Enter the name of the vendor described by Section 176.001(7), Local Government Code, if the vendor: a) has an employment or other business relationship with the local government officer or a family member of the officer as described by Section 176.003(a)(2)(A), Local Government Code; b) has given to the local government officer or a family member of the officer one or more gifts as described by Section 176.003(a)(2)(B), Local Government Code; or c) has a family relationship with the local government officer as defined by Section 176.001(2-a), Local Government Code. 4. Description of the nature and extent of each employment or other business relationship and each family relationship with vendor named in item 3. Describe the nature and extent of the employment or other business relationship the vendor has with the local government officer or a family member of the officer as described by Section 176.003(a)(2)(A), Local Government Code, and each family relationship the vendor has with the local government officer as defined by Section 176.001(2-a), Local Government Code. 5. List gifts accepted, if the aggregate value of the gifts accepted from vendor named in item 3 exceeds $100. List gifts accepted during the 12-month period (described by Section 176.003(a)(2)(B), Local Government Code) by the local government officer or family member of the officer from the vendor named in item 3 that in the aggregate exceed $100 in value. 6. Signature. Signature of local government officer. Complete this section after ydu finish the rest of this'report. You have the option to either: (1) take the completed form to a notary public where you will sign above & f'f'A line that says "Signature of Local Government Officer" (an electronic signature is not acceptable) and your signature will be notarized, or (2) sign above both lines that say "Signature of Local Government Officer (Declarant)" (an electronic signature is not acceptable), and fill out the unsworn declaration section. Local Government Code § 176.001(2-a): "Family relationship" means a relationship between a person and another person within the third degree by consanguinity or the second degree by affinity, as those terms are defined by Subchapter B, Chapter 573, Government Code. Local Government Code § 176.003(a)(2)(A): (a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if: (2) the vendor: (A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that: (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor. Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 THE STATE OF TEXAS § COUNTIES OF GALVESTONIHARRIS § AFFIDAVIT OF CONFLICT OF INTEREST I, Mike Foreman, as a member of the Friendswood City Council make this affidavit and hereby, on oath, state the following: 1, and/or a person or persons related to me in the first degree of consanguinity or affinity, have a substantial interest in: i ® the below -described business entity in that an action on the matter will have a special economic effect on the business entity that is distinguishable from the effect on the public or ❑ the below -described real property in that it is reasonably foreseeable that an action on the matter will have a special economic effect on the value of the property distinguishable from its effect on the public. The business entity or real property is: Reporter News Name/Description of real property 2407 Park Avenue, Pearland, Texas 77581 Address of business/real property I, and/or a person or persons related to me in the first degree of consanguinity or affinity, have a substantial interest in this business entity/real estate for the following reasons: ❑ Ownership of 10% or more of the voting stock or shares of the business entity; or 9 Ownership of 10% or more of the fair market value of the business entity; or ❑ Ownership of $15,000 or more of the fair market value of the business entity; or ❑ Equitable or legal ownership in real property having a fair market value of $2,500 or more; or ❑ Receipt of funds from the business entity exceeds 10% of my/my relative's gross income for the previous year. (check all that apply). Upon the filing of this affidavit with the City Secretary, I affirm that I shall abstain from any discussion, vote, or decision involving the above -referenced business entity or real property and from any further participation in this matter whatsoever at the Council meeting held on March 7, 2022. Signed this 7" day of March, 2022. BEFORE ME, the undersigned authority, this day personally appeared Mike Foreman a member of the City Council of the City of Friendswood, Texas, and on oath stated that the facts hereinabove stated are true and correct to the best of his/her knowledge or belief. Sworn to and subscribed before me on this 7"' day of#arch,_2022. �p LETICIA C EIRYSCH MM. EXPIRES 12.04.2022 NOTARY 10 1259=7-0 Notary Public in and f< CAUsers'Ibq•sch\Af t\W1ndoXvS1T1MC ontent.0udook\138HZ5AGC Conflict of Interest -Council - State of Texas does