2022-01-06-Hornig-OCPF - Laserfiche WebLink

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DISCLOSURE BY S"ECTAL MUNICIPAL EMPLOYEE OF FINANCIAL INTER EST IN A MUNICIPAL CONTRACT AS REQUIRE; i BY G. L. c. 268A, § 20(c) . . . SPECIAL MUNICIPAL. Ek'': LOYEE INFORMATION tF Name of special municipal Charles Hornig .� � � employee: y1C s 0 I am a special municipal employee because: Put an X beside one _1 am a selectman in a town with a population of 10,000 or fewer people; statement. X_I am not a mayor, alderman or city councilor, and _X_ I serve in a municipal position for which no compensation is provided, or I earned compensation for fewer than 800 hours in the preceding 365-day period, or By the classification of my position by my municipal agency or by the terms of a contract or my conditions of employment, I am permitted to have personal or private employment during normal business hours. I work for a company or organization which has a contract with a municipal agency, and I am a "key employee" because the contract identifies me by name or it is otherwise clear that the municipal is contracting for my services in particular, and the contract states that I am a special municipal employee or indicates that I meet one of the three requirements listed above. Title/ Position Member, Planning Board If you are a special municipal employee because a municipal agency has contracted with your Fill in this box company or organization, please provide the name and address of the company or organization. if it applies to you. Municipal Agency/ This is"my Municipal Agency." Department: Town of Lexington Planning Board Agency Address: 1625 Massachusetts Avenue Lexington, MA 02420 Office phone: 781-698-4560 Office e-mail: planning@Iexingtonma.gov Check one: _X_ Elected or Non-elected Starting date as a March 7, 2005 special municipal employee.