id,filename,year,name,title,agency,content
00155388bfeb5374c33feb3d289256d7baf8634d888f6edfcb5e3d5088dcab1f,2021/Keenan_John_Section_23_disclosure_2.22.2021_2.pdf,2021,John F. Keenan,,State Senate,"DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. C. 268A, § 23(b)(3) PUBLIC EMPLOYEE INFORMATION Name of public employee: John F. Keenan Title or Position: State Senator, Norfolk and Plymouth District Agency/Department: State Senate Agency address: State House Room 413F Boston, MA 02133 Office Phone: 617-722-1494 Office E-mail: John.Keenan@MASenate.gov In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue that is coming before Several bills have been filed relative to pensions and benefits for municipal employees, you for action or and relative to the roles, responsibilities and obligations of municipal employees. decision. What responsibility As a member of the State Senate, I will be involved in the review and consideration of do you have for such bills, and will vote on them should they reach the Senate floor. taking action or making a decision? Explain your I have a brother, Paul Keenan, who is employed by the City of Quincy as Chief of Police. relationship or I have a brother, Matthew Keenan, who is employed by the City of Quincy as a firefighter. affiliation to the I have a sister, Catherine Maloney, who is employed by Quincy College. person or I have a sister, Christine Koch, who is employed by the Quincy Public Schools. organization. How do your official actions or decision My siblings have no direct interest in the legislation nor will they benefit financially, or in matter to the person any way different from any other municipal employee, should any of the legislation or organization? become law. Optional: Additional facts - e.g., why there is a low risk of undue favoritism or improper influence. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, Taking into account the facts that I have disclosed above, I feel that I can perform my you should recuse yourself. official duties objectively and fairly. Employee signature: John FiKeenan Date: 2/22/21 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised July, 2012"
0021e3a805551473f9e8ac37a0c2d765a2e0eb8f44fc9e4932c2d978d8925b11,"2023/Oliveira,_Jacob_930CMR5.082d2_disclosure_5.27.23.pdf",2023,Jacob Oliveira,,Massachusetts State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Jacob Oliveira Title/ Position State Senator Agency/ Department Massachusetts State Senate Agency address: 24 Beacon St. Room 416-B Boston, MA, 02133 Office phone: (617) 722-1291 Office e-mail: Jacob.Oliveira@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. _X__ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I will be joining other elected political leaders in Lisbon, Portugal, to participate in traveling. meetings bringing together Portuguese and Portuguese American elected officials at the Luso-American Legislators' Dialogue. Describe your participation in the During this event, I will meet with Portuguese and United States officials and attend activity. panels on the history and future of Portuguese American communities. Date, time and location June 1 - 2, 2023 of activity. Lisbon, Portugal Please explain how the Massachusetts is home to a large Portuguese American community, and there are activity will promote the significant economic, cultural, educational, and other issues of mutual interest to interests of the Portugal and Massachusetts. My participation in this event will promote the bilateral Commonwealth, a county relationship between the United States and Portugal. or a municipality. TRAVEL EXPENSES Identify the person or organization that The Luso-American Development Foundation (FLAD) offered to reimburse, waive or pay your travel expenses. Address of person or organization. Rua Sacramento à Lapa, 21 1249-090 Lisbon, Portugal Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: 1914.24 Overnight accommodations. Lodging: 708 Breakfast, lunch, dinner, special events. Meals: 280 Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: 2902.24 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: 5/27/2023 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
00296cc556d7acd9e146f906636606e684d5095a1eda89b9b82b5de44c0d042d,"2017/Farley-Bouvier,_Tricia_6A_1.24.17.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public official: Tricia Farley- Bouvier Public official State Representative position: Public office State House, Room address: Boston, MA 02133 Office Phone: 617-722- Office E-mail: @mahouse.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action The General Court intends to consider the issue of compensation adjustments for certain to be taken: public officials, including constitutional officers and legislators. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: As a committee member and as a state representative from, my compensation may be adjusted. Public official's signature: Date: 1/24/17 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0046d565ee42919c5ea6df1708f55aafab31e20d4b767ad98e013cacd0c0b47b,"2017/McKeever,_Kate_section_6_disclosure_3.6.17.pdf",2017,Kate McKeever 2017 MAR - -6 AM 54,,EEA,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Kate McKeever 2017 MAR - -6 AM IO: 54 Title or Position: General Counsel State Agency: EEA Agency Address: 100 Cambridge Street Office Phone: 617-626-1120 Office E-mail: Kate.mckeever@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Pursuant to the Summary of the Conflict of Interest Law, a financial interest which is remote, speculative, or not sufficiently identifiable does not create conflicts. However, in an abundance of E.g., a judicial or other caution, I wanted to disclose that I am negotiating with Enel Green Power North America. I have no proceeding, application, official authority over Enel, no official dealings with Enel, and have not participated in any particular submission, request matter with respect to Enel. for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required participation in the I am not participating in a particular matter that involves Enel particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. X I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest I don't think there is a financial interest. in the matter Employee signature: Kate McKeever Date: January 30, 2017 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Matthew A. Beaton Authority: Title or Position: Secretary Agency/Department: EEA Agency Address: 100 Cambridge Street Office Phone: 617-626-1000 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: January 30, 2017 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0048879774adf56b0d6d6649fad75a2be7d523dc00c8838f438dd6b83f4dcd4a,"2019/Moore,_Michael_Addendum_to_930CMR5.082d2_Disclosure_10.16.2019.pdf",2019,Michael O. Moore,,Massachusetts Legislature,"Addendum 2019 OCT 18 AM 10: 51 DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected Michael O. Moore public employee: Title/ Position State Senator Agency/ Department Massachusetts Legislature Agency address: Room 109B, State House, Boston, MA 02133 Office phone: 617-722-1485 Office e-mail: Michael.Moore@MAsenate.gov Write an X to I am filing this disclosure because: confirm each statement. _X_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity Fall Global Advisory Committee Meeting and Training which is the reason for traveling. Describe your I am a member of the Global Advisory Committee which makes policy participation in the recommendations to the U.S. Attorney General activity. Date, time and Office of Justice Programs location of activity. 810 Seventh Street, NW Washington, DC 20531 As the Senate Chair of Public Safety and Homeland Security I represent the Please explain how the MA Senate and my participation in this group gives Massachusetts a voice at activity will promote the the national level on policy issues that will affect the commonwealth. interests of the Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or Christina Abernathy organization that Manager/Senior Research Associate offered to reimburse, Institute for Intergovernmental Research (IIR) Phone: 850.385.0600 X 318 waive or pay your Mobile: 850.566.6584 travel expenses. P.O. Box 12729, Tallahassee, FL 32317-2729 Email: cabernathy@lir.com Address of person or Phone: 850.385.0600 X 318 organization. Mobile: 850.566.6584 P.O. Box 12729, Tallahassee, FL 32317-2729 Email: cabernathy@iir.com Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Flight $243.96 Overnight accommodations. Embassy Suites DC Convention Center 900 10th Street NW Lodging: Washington DC 20001 Meeting rate of $275.88 per night, plus tax, single or double occupancy Breakfast, lunch, dinner, special events. Meals: Included in subsidy and my costs $133.00 Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Included in subsidy and my costs. Total: $652.57 Write an X beside I have attached the relevant itinerary. any relevant statement. I have attached the relevant agenda. For the exemption Having disclosed the facts above, I determine that: to apply, check off Acceptance of the reimbursement, waiver or payment of travel expenses will both statements. serve a legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county or a municipality; AND Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: October 15, 2019 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. From: John Mountjoy [mailto:jmountjoy@csg.org] Sent: Monday, October 07, 2013 11:30 AM To: Moore, Michael O (SEN) Subject: CSG Federalism Fly-In - Washington, DC - Nov. 12-13, 2013 Senator Moore: The Council of State Governments has worked for over 80 years to advance excellence in state government. A cornerstone of this mission is promoting effective state-federal cooperation. To that end, we are honored to have you serve as a member of the CSG Federalism Task Force, charged with exploring options for improving the state-federal relationship. This new two-year effort is not aimed at advancing a specific policy agenda, but instead seeks to better understand the respective state and federal roles in our shared federalism model and investigate ways in which the state-federal relationship may be enhanced. After our successful Federalism Forum during CSG's 2013 National Conference in Kansas City last month, the next step is to travel to Washington, DC to work directly with our leaders in the federal government. We have scheduled this important meeting for November 12-13, 2013 and my staff is in the process of organizing a valuable program to foster engagement with our federal counterparts. You will find a preliminary agenda attached. CSG is pleased to cover your travel and lodging expenses associated with this meeting. Travel arrangements may be made by contacting Altour Travel at (800) 445-0419; ref: CSG Federalism Fly-In. You may travel to Washington, DC on Nov. 11 or Nov. 12 / departure late on Nov. 13 or Nov. 14 - lodging will be provided based on your travel requirements. Lodging will be provided at The Liaison Capitol Hill and CSG will make your lodging arrangements directly; a confirmation code will be provided. Meetings will take place at various locations around Washington, DC and onsite transportation between meeting locations will be provided. Should you have questions about the content of this meeting or logistics, please contact me directly at (859) 244-8256 or imountioy@csg.org; or JC Hendrickson, CSG's Director of Legislative Affairs in our Washington, DC office at (202) 624-3539 or jhendrickson@csg.org. On behalf of CSG's leaders, thank you for your participation in this invaluable discussion. I look forward to seeing you in Washington, DC. John John Mountjoy Director of Policy, Research & Strategic Initiative The Council of State Governments 2760 Research Park Dr. Lexington, KY 40511 859.244.8256 office 859.420.3372 mobile jmountioy@csg.org www.csg.org October 7, 2013 CSG Federalism Task Force - Washington, DC Fly-In November 12-13, 2013 Dear CSG Federalism Task Force Member: The Council of State Governments has worked for over 80 years to advance excellence in state government. A comerstone of this mission is promoting effective state-federal cooperation. To that end, we are honored to have you serve as a member of the CSG Federalism Task Force, charged with exploring options for improving the state-federal relationship. This new two-year effort is not aimed at advancing a specific policy agenda, but instead seeks to better understand the respective state and federal roles in our shared federalism model and investigate ways in which the state-federal relationship may be enhanced."
004dba10d24a518092d758e5c426557192e78ea284137e04b4d930b7313ef6dd,2014/SkarinKathleen.pdf,2014,Kathleen Skarin 2014 APR - 1 AM 9:42,,Middlesex Sheriff's Office,"The Commonwealth of Middlesex Sheriff's Office 2014 APR - 1 AM 9:42 Peter J. Koutoujian Sheriff 400 Mystic Avenue Medford, Massachusetts 02155 Phone (781) 960-2800 Fax (781) 960-2902 March 31, 2014 Karen L. Nober Executive Director State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Re: Disclosures of Financial Interest Dear Ms. Nober: Enclosed are disclosures pursuant to G.L. c. 68A, Section 6, from employees of the Middlesex Sheriff's Office, and Determinations by the Appointing Official, Sheriff Peter Koutoujian. Please contact me if you have any questions. Sincerely, LaDonn Hitth LaDonna J. Hatton Chief Legal Counsel 781.960.2813 www.middlesexsheriff.com Printed in-house Xerox C2C DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Kathleen Skarin 2014 APR - 1 AM 9:42 Title or Position: Chief of Staff State Agency: Middlesex Sheriff's Office Agency Address: 400 Mystic Avenue Medford, MA 02155 Office Phone: 781-960-2800 Office E-mail: kgskarin@sdm.state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter E.g., a judicial or other proceeding, application, Decision about an increase in salary and benefits for at-will employees. submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required participation in the particular matter: As the Chief of Staff, I am required to participate in matters relating to employee salaries and E.g., approval, benefits. disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. 1 am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Because I am an at-will employee, my salary and benefits will be impacted by the in the matter decision. Employee signature: Kattleeg Stari Date: 3/18/14 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Peter J. Koutoujian Title or Position: Middlesex Sheriff Agency/Department: Middlesex Sheriff's Office Agency Address: 400 Mystic Avenue Medford, MA 02155 Office Phone: 781-960-2800 Office E-mail Pjkoutoujian@sdm.state.ma.us DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: 2 Date: 3/28/14 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
004e06bdd3b9f1c7be85e3346fd6b451b9d8fa916f6428fdad1f06d18967682e,"2022/Fowler,_Mary_1.10.22_-_Cmr_6.06(2).pdf",2022,Mary Fowler,,,"RECEIVED STATE ETHICS COMMISSION 2022 JAN 1.0 AMII: 32 DISCLOSURE BY STATE EMPLOYEE OF A FINANCIAL INTEREST IN A CONTRACT TO PROVIDE SERVICES FOR THE COMMITTEE FOR PUBLIC COUNSEL SERVICES AS REQUIRED BY 930 CMR 6.06(2) STATE EMPLOYEE INFORMATION Name of state Mary Fowler employee: Title/ Position Please provide information about your state employee position. Professor Agency: Worcester State University Agency address: 486 Chandler Street Worcester, MA 01602 Office phone: 508-929-8576 Office e-mail: mfowler@worcester.edu I am a state employee. The Committee for Public Counsel Services (""CPCS"") provides representation and services to persons with regard to various matters in the state courts and assigns attorneys and personnel to work on the matters. In connection with these matters, I expect to provide representation or services to, or on behalf of, such persons, attorneys or personnel. I respectfully request written approval of the arrangement from CPCS and (if I am not an elected state employee) from my appointing authority in my state position. CPCS SERVICES Describe the nature of the representation or services you expect to Statistical expert testimony in defense of provide to or for Jose Serratos CPCS. with Attorney Jose Serratos If you are providing services through a company, please Racial Equity Partners, LLC provide its name and address, Who will pay you for your services? CPCS, directly. An attorney or personnel assigned by CPCS, If not CPCS, please provide the name and address of the person or entity who will pay you or your company for your services. What is your financial Please explain your financial interest and provide the dollar amount if you know it. interest in providing these services? I am being contracted to provide statistical analysis which might include writing a report and giving testimony. Please include both compensation and The court allowed a motion for $2,500. Depending on what is found in the data analysis, the obligations, etc. project could further require additional funds. I approximate the additional funds could be as high as $10,000. Employee signature: ManStawn 10/12/2021 APPROVAL BY COMMITTEE FOR PUBLIC COUNSEL SERVICES Name and title of CPCS employee giving approval Attorney Brian DeMott Office phone 508-368-1850 Office e-mail bdemott@publiccounsel.net Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed CPCS employee above BR and approve the arrangement proposed by the state employee. Date: 10/12/21 FOR NON-ELECTED STATE EMPLOYEES ONLY: APPROVAL BY APPOINTING AUTHORITY AT STATE AGENCY WHICH YOU SERVE Name and title of appointing authority. or Linda Larrivee his or her designee, at Dean School of Education, Health and Natural Science the state agency which you serve Office phone 508-929-8333 Office e-mail llarnvee@worcester.edu Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed appointing authority above approve the arrangement proposed by the state employee. Date: 12/6/2021 Attach additional pages If necessary. File copy with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised March, 2013 What is your financial Please explain your financial interest and provide the dollar amount if you know it. interest in providing these services? A motion for funds has been approved for $475. If more work is needed from me on this case, it could be as much as an additional $2,500 or more depending on what is needed. Please include both STATE ETHIGS COMMISSION compensation and obligations, etc. 2022 JAN 10 AM11:32 Employee signature: mary Stoully 10/24/2021 APPROVAL BY COMMITTEE FOR PUBLIC COUNSEL SERVICES Name and title of CPCS employee giving approval Attorney Connor Barusch Office phone 617-209-5500 Office e-mail cbarusch@publiccounsel.net Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed CPCS employee above and approve the arrangement proposed by the state employee. on Date: 11/9/21 FOR NON-ELECTED STATE EMPLOYEES ONLY: APPROVAL BY APPOINTING AUTHORITY AT STATE AGENCY WHICH YOU SERVE Name and title of appointing authority, or Linda Larrivee his or her designee, at Dean School of Education, Health and Natural Science the state agency which you serve Office phone 508-929-8333 Office e-mail llarrivee@worcester.edu Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed appointing authority above and approve the arrangement proposed by the state employee. Date: 12/6/2021 Attach additional pages if necessary. File copy with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised March, 2013 DISCLOSURE BY STATE EMPLOYEE"
004e4fec490ba4484f42a5abcfca2ea82846971170beeebf45f3d46705fd7e79,"2023/Cronin,_John_930_CMR_5.08(2)(d)3_disclosure_11.21.23.pdf",2023,JOHN J. CRONIN,,Massachusetts Senate,"RECONCILIATION STATEMENT AS REQUIRED BY 930 CMR 5.08(2)(d)3. PUBLIC EMPLOYEE INFORMATION Name of employee: JOHN J. CRONIN Title/ Position Massachusetts State Senator Agency/ Department Massachusetts Senate Agency address: Massachusetts State House 24 Beacon Street, Rm. 218 Boston, MA 02133 Office Phone: 617-722-1230 Office E-mail: JOHN.CRONIN@MASENATE.COV I previously filed a disclosure explaining that I accepted reimbursement, waiver or payment by a non-public entity (but not a lobbyist) of travel expenses related to an activity or speaking engagement that served a legitimate public purpose. I am filing this Reconciliation Statement because the actual amount of the travel expenses differed by more than $50 from the amount I originally disclosed. I HAVE ATTACHED A COPY OF MY PREVIOUS DISCLOSURE. ADDITIONAL EXPENSES Date of activity or August 23 - 26, 2023 speaking American Irish State Legislators Caucus engagement: 25th Anniversary of the Good Friday Agreement Programming Reason that the At the time of submitting the disclosure, I had not yet received receipts or itemized actual amount differs statements for transportation, meals, or admission costs. I am filing this reconciliation from the previously statement now that I have received the costs that were covered on this trip. disclosed amount by $50 or more: PLEASE INCLUDE DETAILED INFORMATION ONLY ABOUT AMOUNTS THAT DIFFER FROM THE AMOUNTS ORIGINALLY DISCLOSED. Previously disclosed amount Actual amount Transportation: $0 $82.23 Lodging: N/A N/A Meals: $0 $235.86 Admission: $0 $50.50 Other (please list): N/A N/A Total: $0 $368.59 (Conversions from € and £ to $ on 9/26/2023.) Employee signature flu J.C. Date 10/4/2023 Attach additional pages if necessary. Non-elected public employees - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the Senate or House Clerk or the State Ethics Commission. Elected municipal employee - file with the city or town clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
0050b199a5138f50e516098a3ee54b8495638bd71a5f7e06a22439c83328b409,"2023/Wolfenden,_Toni_K._5.8.23_-_23(b)(3).pdf",2023,Toni K. Wolfenden,,Health Department,"DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. C. 268A, § 23(b)(3) PUBLIC EMPLOYEE INFORMATION STATE RECEIVED COMMISSION Name of public employee: Toni K. Wolfenden 2023 MAY -8 AH1021 Title or Position: Administrative Assistant Agency/Department: Health Department Agency address: 120 Main Street North Andover, MA 01845 Office Phone: 978-688-9540 Office E-mail: twolfenden@northandoverma.gov. In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue that is coming before Various septic issues. you for action or decision. What responsibility do you have for I forward septic plans to be reviewed to the Town Septic Consultant. taking action or making a decision? Explain your relationship or My son, John A. Wolfenden is a surveyor for Andover Consultants Inc., located at 1 East affiliation to the River Place Methuen, MA 01844. Andover Consultants from time to time will send septic person or plans to the health department to be reviewed and approved for homes in North Andover. organization. How do your official actions or decision Process septic plans and files. matter to the person or organization? Optional: Additional facts - e.g., why There is low risk of undue favoritism because I do not approve any of the septic plans. there is a low risk of undue favoritism or improper influence. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, _x_______________________ Taking into account the facts that I have disclosed above, I feel that I can perform my you should official duties objectively and fairly. recuse yourself. Employee signature: ToniK. Wolfenden Date: 05.03.2023 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised July, 2012"
0050f1dc16015889b1a0b86dc9ca9aa1325d02121d813d9490309aacff8e50c4,"2013/Gonzalez,_Jay_section_6_disclosure_2013-01-05.pdf",2013,Jay Gonzalez 2013 JAN 23 AM 10: 38,,Office of the Governor,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Jay Gonzalez 2013 JAN 23 AM 10: 38 Title or Position: Secretary State Agency: Executive Office for Administration and Finance Agency Address: State House, Room 373 Boston, MA 02133 Office Phone: 617-727-2040 Office E-mail: Jay.Gonzalez@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter As chair of the Commonwealth Health Connector Authority and a statutory member of the Group Insurance Commission and the new Health Policy Commission, I participate in numerous particular E.g., a judicial or other matters that affect the financial interests of health insurers. proceeding, application, submission, request As Secretary, I also participate in certain budgetary matters that affect the financial interests of for a ruling or other health insurers. determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required See above. participation in the particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest in the matter I spoke recently with a representative of CeltiCare Health Plan of Massachusetts (a subsidiary of Centene Corporation), a health insurance carrier, to discuss prospective employment opportunities. Employee signature: 890 Date: 1/5/13 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Deval L. Patrick Title or Position: Governor Agency/Department: Office of the Governor Agency Address: State House, Room 360 Boston, MA 02133 Office Phone: (617) 725-4000 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: Comment: While you are engaged in discussions with this organization about prospective employment, you should abstain from any involvement in matters that may affect this organization. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0055031ae259715bc22e1f563173a0fbc342b02abb2606e8a9c5581f5bee3592,"2017/Walsh,_Christopher_4.24.17_-_6A.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. c. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public official: Chris waish Public official State Representative position: Public office State House, Room 473G address: Office Phone: 617-722-2070 Office E-mail: @mahouse.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN I intend to discuss, vote on, and otherwise participate in the development, debate and Official action enactment of the Fiscal Year 2018 General Appropriations Act. There are two floor to be taken: amendments to House 3600, the House Committee on Ways and Means' budget proposal, pending before the House of Representatives; which would impact certain benefits offered through the Group Insurance Commission. One would cap out of pocket health care expenses, and one would increase life insurance benefits. I anticipate that similar proposals may be made over the course of budget deliberations. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I am an active state employee who receives health insurance and life insurance through the Group Insurance Commission. Therefore, if enacted, these proposals may impact my insurance costs and benefits. Public official's signature: Date: Gegloda Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
005958759791302d51275848141e55973b63f41ae362f3bacb83cecdd849e410,2014/LyneisAnne.pdf,2014,Anne Lyneis,,Match Charter Public School and Match Community Day Charter Public School,"§6 Determination RECEIVED STATE ETHICS COMMISSION DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST 7014 MAY 28 AM IO: 35 AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Anne Lyneis Title or Position: Teacher at Match Charter Public School (the ""Match School"") State Agency: Match Charter Public School and Match Community Day Charter Public School (collectively with the Match School, the ""Schools"") Agency Address: 1001 Commonwealth Avenue Boston, MA 02215 Office Phone: (617) 232-0300 Office E-mail: anne.lyneis@matcheducation.org My duties to the Match School require me to participate in a particular matter in which an organization with whom I am negotiating an arrangement concerning prospective employment has an interest, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other I am a teacher at the Match School, and I am negotiating prospective employment with The MATCH proceeding, application, School Foundation, Inc. (the ""Foundation""). The Foundation may make donations to the Schools submission, request for a ruling or other and may provide services to the Schools. In particular, the Foundation donates back office support to the Schools, and the Foundation may hold fundraisers for the benefit of the Schools. determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: I teach students at the Match School. As a donor to the Match School, the Foundation has an interest in the operations of the Schools, including in the quality of teaching at the Match School. In E.g., approval, addition, I may be required to attend fundraisers held by the Foundation for the benefit of the disapproval, decision, Schools. recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. 1 am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter Donations to Schools: The value of back-office services donated to the Schools by the Foundation is not ascertainable. In fiscal year 2014, the Foundation expects to donate up to $500,000.00 to the Schools. Employee signature: Ame lyness Date: May 23 232014 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Stig Leschly Authority: Title or Position: Chief Executive Officer Agency/Department: Match Charter Public School and Match Community Day Charter Public School Agency Address: 1001 Commonwealth Avenue Boston, MA 02215 Office Phone: (617) 232-0300 Office E-mail sleschly@matcheducation.org DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: By: Stig Leschly, Match Charter Public School and Match AS Chief Executive Luy Officer of Community Day Charter Public School Date: May 21 , 2014 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0062f51ab607ff851fb6fe7220daac9ada90a7121c89c7453d0ce653fefbfe2a,"2015/Lesser,_Eric_930CMR5.082d2_disclosure_2015-02-12.pdf",2015,Eric P. Lesser,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. RECEIVED ELECTED PUBLIC EMPLOYEE INFORMATION COMMISSION Name of elected 2015 FEC FEC 12 PM 3:45 public employee: Eric P. Lesser Title/ Position State Senator Agency/ Department Massachusetts Senate Agency address: 24 Beacon Street, Boston, MA 02133 Office phone: 617-722-1291 Office e-mail: Eric.Lesser@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for North American Federation of Temple Youth (NFTY) conference. traveling. Describe your participation in the As an alumnus of the conference, I will be a featured speaker during the opening activity. plenary. Date, time and location of activity. February 13, 2015 - February 14, 2015, Atlanta, GA. Please explain how the activity will promote the Attendance and participation in the conference will allow me to better understand interests of the Commonwealth, a county issues affecting Jewish youth in my district and throughout the Commonwealth. or a municipality. TRAVEL EXPENSES Identify the person or organization that Union for Reform Judaism offered to reimburse, waive or pay your travel expenses. Address of person or organization. 633 Third Avenue New York, NY 10017-6778 212-650-4000 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Flight, $416.20 Overnight accommodations. Lodging: Hotel, $165 Breakfast, lunch, dinner, special events. Meals: Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Conference registration, $175 Total: $756.20 Write an X beside any I have attached the relevant itinerary. relevant statement. _X_ I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Eri P. fer Date: 2/12/2015 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 URJ NFTY CONVENTION 2015 FEBRUARY 13 - 17 ATLANTA, GEORGIA NFTY Convention and Youth Summit Event Guide Thousands of Jewish teens and adults will come together for the NFTY Convention and Youth Summit February 13 through 17, 2015, in Atlanta, GA. NFTY, which celebrates its 75th anniversary this year, is the Reform Jewish Youth Movement. NFTY Convention will attract more than 1,000 teens from across North America. They will be joined by nearly 200 adult lay leaders, professionals, congregants, clergy and stakeholders who will attend the concurrent Youth Summit at NFTY Convention. Throughout the weekend the Convention website, www.nftyconvention.org will be updated regularly with blog posts, photos, videos and social media highlights. #NFTYCONVENTION #NFTYYS Events with an asterisk (*) will be streamed live on the NFTY website, on the JLTV cable television channel and on mobile devices using the JLTV app. More details are available at www.nftyconvention.org/live. Jewish Rock Radio will air the NFTY Convention Countdown and Ruach 5775 Preview on Tuesday, February 10 at 8:30 ET/5:30 PT. The show can be streamed at www.jewishrockradio.com, www.nftyconvention.org/live or the Jewish Rock Radio mobile app. NFTY Convention Friday, February 13, 2015 As participants arrive in Atlanta, they'll be greeted by the NFTY North American Board, college-age resident advisors, and NFTY/URJ staff. They will reconnect with friends from NFTY regional programs, URJ Camps and NFTY Israel trips, and meet new teens from across North America. The Convention will open with an intergenerational Shabbat celebration filled with joyous music, worship and dancing. Experiential Shabbat Tfilah (worship) Learners Minyan (learning about prayers and how to be an inclusive tfilah leader) Music around the world Musical Mashup (each prayer will be mashed up with a secular song) Shabbat dinner with all NFTY teens and Youth Summit adults Opening Plenary* Welcome to Atlanta Greetings from Stephen Sacks, Chair of URJ Board of Trustees Greetings from NFTY North American Board and NFTY Staff Speakers and distinguished alumni: Eric Lesser, MA State Senator and former aide to President Obama who ran first White House Passover Seder Matan Koch, lawyer and advocate for disabilities and special needs who previously served as member of the National Council of Disabilities Shabbat Song Session"
006ac1d9ea6b3f47a400ccb41184dfd2aeb4e9011269d1aa0e136cafd7ebe163,2014/ShorGlen.pdf,2014,Glen Shor,,,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Glen Shor 2014 NOV 25 M 9:27 Title or Position: Secretary State Agency: Executive Office for Administration and Finance Agency Address: State House, Room 373 Boston, MA 02133 Office Phone: 617-727-2040 Office E-mail: Glen.Shor@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter As A&F Secretary, I prepare the Governor's budget and manage the Commonwealth's budget throughout the fiscal year, including participating in decisions about spending on MassHealth and E.g., a judicial or other other state health programs, including Commonwealth Care, ConnectorCare, Group Insurance proceeding, application, Commission benefits, and health care services under the supervision of the Department of submission, request Correction. for a ruling or other determination, contract, claim, controversy, I am also ex-officio Chair of the Board of the Commonwealth Health Insurance Connector Authority charge, accusation, (""Connector""). G.L. C. 176Q, §2. In that capacity, I participate in decisions to award contracts for the arrest, decision, Commonwealth Care, Commonwealth Choice, ConnectorCare, and other qualified health plan determination, or finding. programs administered by the Connector. I also participate in a range of policy decision making on health care issues, including through state and quasi-public agencies on which I serve (the Connector and the Health Policy Commission) and related to the activities of other state agencies (such as the Division of Insurance). Your required See above. participation in the particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest I am engaged in discussions about a senior-level position at New Hampshire Healthy Families, in the matter which is underwritten by Granite State Health Plan. Granite State Health Plan is a wholly-owned subsidiary of the Centene Corporation. The Centene Corporation has a financial interest in matters within my purview as Secretary of Administration and Finance. This is because CeltiCare Health Plan of Massachusetts - also a subsidiary of Centene - is a managed care organization that provides health insurance to eligible residents of Massachusetts, including through the state's MassHealth program and through the Connector. Moreover, Jay Gonzalez is the President and CEO of both CeltiCare Health Plan and New Hampshire Healthy Families. Finally, the Massachusetts Partnership for Correctional Health - a subsidiary of a joint venture between Centene and MHM Services, Inc. - provides health care services to individuals incarcerated in Massachusetts state correctional facilities. Employee signature: MA Date: 11/21/14 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Deval L. Patrick Authority: Title or Position: Governor Agency/Department: Agency Address: State House, Room 360 Boston, MA 02133 Office Phone: 617-727-4030 Office E-mail Jamie.Hoag@state.ma.us DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: Comment: 25 - Wovember 2014 Please recuse. I am assigning this particular matter to Katie Hammer or her designee. Attach additional pages if necessary. File copy with:"
006ea20aed3ab1d2a2f6b3dcb632ce18ac95625516b0d57f6195074f6729e925,"2013/Garlick,_Denise_930_CMR_5.08(2)(d)3_-_1.25.13.pdf",2013,Denise Garlick,,House of Representatives,"SEC DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. STATE ETHICS RECEIVED COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION 2013 JAN 25 PM 12: 46 Name of elected Denise Garlick public employee: Title/ Position State Representative Agency/ Department House of Representatives Agency address: State House, Room 236 Boston, MA 02133 Office phone: 617-722-2430 Office e-mail: Denise.Garlick@mahouse.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _X__ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity Attending the Harvard Kennedy School program entitled ""Shaping Healthcare Delivery which is the reason for Policy."" traveling. Describe your I will be a government official participating as a student in an executive education participation in the program for healthcare leaders. activity. Date, time and location January 27 February 1. 2013 of activity. Harvard Kennedy School/Executive Education 79 JFK Street Cambridge, MA 02138 Please explain how the This program is a professional development seminar which will better inform me as I activity will promote the represent my constituents (reportedly as much as 1 in 9 are employed in the interests of the healthcare field); and will prepare me for legislative discussions on the future of Commonwealth, a county healthcare. or a municipality. TRAVEL EXPENSES Identify the person or The Harvard Kennedy School has provided me with a $3,750 scholarship which will be organization that covering half of the cost of the program fee ($7,500). offered to reimburse, waive or pay your travel expenses. Address of person or Harvard Kennedy School/Executive Education organization. 79 JFK Street Cambridge, MA 02138 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: N/A Overnight accommodations. Lodging: Included in program fee. Breakfast, lunch, dinner, special events. Meals: Included in program fee. Registration, admission, tickets, etc. Admission: $3,750 Refreshment, instruction, materials, entertainment, etc. Other (please list): Included in program fee. Total: $3,750 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: Denie January 25, 2013 9.Sal Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 HARVARD Kennedy School Executive Education NEW! EXECUTIVE EDUCATION PROGRAM FOR JANUARY 27-FEBRUARY 1, 2013 HEALTHCARE LEADERS SHEILA BURKE ASHISH JHA KATHERINE BAICKER DAVID BLUMENTHAL DON BERWICK ELLEN ZANE THOMAS GLYNN AMITABH CHANDRA FACULTY CO-CHAIR FACULTY CO-CHAIR Shaping Healthcare Delivery Policy: Understanding the Challenges, Managing the Change American healthcare is changing. Understanding, managing, and leveraging change in the healthcare sector are at the center of Harvard Kennedy School's newest Executive Education program. Spend a week at Harvard collaborating with fellow healthcare leaders to create your own roadmap for change in healthcare. ENGAGE WITH THE NATION'S TOP HEALTHCARE EXPERTS www.hks.harvard.edu/ee/shcp For more information on admission deadlines and tuition, please visit www.hks.harvard.edu/ee/shcp. Shaping Healthcare Delivery Policy: Understanding the Challenges, Managing the Change is a new Harvard Kennedy School Executive Education program that will bring together leaders in healthcare from the public, private and nonprofit sectors to explore the myriad issues and opportunities within the industry, and increase their preparedness for change in American healthcare. Leaders with active roles in all areas of American healthcare should consider applying, including: » Physicians » Hospital administrators » Medical device manufacturers » Health insurance executives ». Pharmaceutical and life science executives » Government officials » Community Health Center directors Admission is competitive and will be based on professional achievement and organizational responsibility. All admitted participants will receive a certificate from Harvard Kennedy School upon successful completion of the one-week program."
00727199e122a03d320704ba2b008ba52c13dce1a4ce74ff57f0dc48136caed5,2014/Vallely_Bartlett_Maeve_Disc.pdf,2014,Maeve Vallely Bartlett,,Office of the Governor,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE RECEIVED ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Maeve Vallely Bartlett 2014 NOV 5 PM 12. Title or Position: Secretary State Agency: Executive Office of Energy and Environmental Affairs (EEA) Agency Address: 100 Cambridge Street, Boston, MA Office Phone: 617-626-1101 Office E-mail: Maeve.vallelybartlett@state.ma.us My duties require me to participate in a particular matter, and 1 may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter I recently had a meeting with Eleanor Tillinghast on an energy related matter. She unexpectedly E.g., a judicial or other arrived with her attorney, Vincent DeVito of Bowditch & Dewey, a law firm where my husband is proceeding. application, employed. I excused myself from the meeting and will continue to recuse myself from this matter, submission, request the facts of which are currently and will remain unknown to me. for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required participation in the As Secretary of EEA, there is a potential that I would be called upon to render a decision particular matter: or to undertake an action in relation to Ms. Tillinghast's interaction with this Secretariat. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. _X_ My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. 1 am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest in the matter My Husband is employed by Bowditch & Dewey, the law firm who has been retained by Ms. Tillinghast to represent her interests with this Secretariat. Employee signature: Date: your 10/24/14 Vallely Bartled DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Deval L. Patrick Title or Position: Governor Agency/Department: Office of the Governor Agency Address: State House, Room 360, Boston, MA Office Phone: 617-725-4000 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: OSah 3 November 2014 Comment: I am assigning this particular matter to Undersecretary for the Environment Martin Suuberg. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0073c2d3a2c7c1fef6ee2f2dbe57983e4e77591f38fd4b987845004a126197e7,"2021/Comerford,_Joanne_Section_6A_disclosure_6.9.21.pdf",2021,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public official: Joanne M. Comerford Public official position: State Senator, Hampshire, Franklin and Worcester Public office address: Massachusetts State House 24 Beacon Street Boston, MA 02133 Office Phone: (617) 722-1532 Office E-mail: Jo.Comerford@masenate.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action to be taken: The Senate is voting on Senate bill 2542, which includes requirements for landlords regarding notices until January 1, 2023. The Senate, as a whole, will be voting on this bill this week. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest involved: I own and manage residential rental housing property as a landlord that will likely be affected by the notice requirements in this bill. Public official's signature: Date: June 9, 2021 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0087eadb03e2859c6970e743d4e7abe4d6ea8f17dce758e6aa14aca31eaa1f10,"2014/Goldstein,_Emma_section_6_disclosure_2014-11-5.pdf",2014,Emma Goldstein,,Office of the Governor,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY AS REQUIRED BY STATE ETRIES STATE EMPLOYEE INFORMATION Name: Emma Goldstein 2014 NOV -5 PH12: 30 Title or Position: Deputy Director of Boards and Commissions State Agency: Office of the Governor Agency Address: State House, Boston, MA Office Phone: 617.725.4010 Office E-mail: Emma.Goldstein@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter As Deputy Director of Boards and Commissions, I manage the vetting and appointment process for gubernatorial appointments to the Board of Directors of the Massachusetts Development Finance E.g., a judicial or other Agency Board of Directors. I do not recommend appointees or otherwise make the final proceeding, application, determination on the appointments. submission, request for a ruling or other determination, contract, I am discussing employment with the Massachusetts Development Finance Agency and, out of an claim, controversy, abundance of caution, am filing this disclosure and recusing myself from handling Agency charge, accusation, appointments. arrest, decision, determination, or finding. Your required As Deputy Director of Boards and Commissions, I manage the vetting and appointment process for participation in the gubernatorial appointments to the Board of Directors of the Massachusetts Development Finance particular matter: Agency Board of Directors. I do not recommend appointees or otherwise make the final determination on the appointments. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest The Massachusetts Development Finance Agency has no direct financial interest in board in the matter appointees. I am filing this disclosure and recusing myself out of an abundance of caution. Employee signature: Date: 10/31/19 I DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Deval L. Patrick Title or Position: Governor Agency/Department: Office of the Governor Agency Address: State House, Boston, MA Office Phone: 617.725.4000 Office E-mail Jamie.hoag@state.ma.us DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: State 3 November 2014 Comment: I designate Chelsey Cartright in the Governor's Office of Boards and Commissions to manage appointments to the Massachusetts Development Finance Agency Board of Directors. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
008b67bfad24abcc15be56b82cf933079cdc6fc89ca3ff1c951fd63040224ad4,"2019/Cecil,_Jeff_10.10.19_-_CMR_5.08(2)(d)1_-.pdf",2019,Jeffrey Cecil,,Boston Police Department Suffolk County District Attorney's Office,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)1. ELECTED PUBLIC EMPLOYEE INFORMATION Name of non-elected Jeffrey Cecil public employee: Title/ Position Detective, Boston Police Department Agency/ Department Boston Police Department Suffolk County District Attorney's Office Agency address: One Bulfinch Place, 7th Floor Boston, MA 02114 Office phone: 617-619-4202 Office e-mail: Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity Security detail accompanying DA Rollins during her participation in the Kennedy which is the reason for Summer School programming traveling. Describe your participation in the activity. Security Date, time and location Wednesday September 4-Sunday September 8. New Ross, Ireland of activity. Please explain how the Please see attached agenda. activity will promote the interests of the Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or organization that Liam 0 Caoite, Kennedy Summer School. offered to reimburse, waive or pay your travel expenses. Address of person or organization. c/o John F Kennedy Trust 35 South Street New Ross Co. Wexford Provide information in as much detail as possible: Transportation: DA office responsible for booking flight. DA office covering rental car. No airport transfers have been provided Creacon Wellness Retreat Lodging: Reservation number 3944/012 & 3944/018 (one room for DA Rollins, the other for her security detail) Two double private rooms from Wednesday, September 4th - Sunday, September 8th creaconwellnessretreat.com phone number: 00 353 51 447 666 Cost for Jeffrey Cecil for 4 nights is €360.00 Breakfast provided by hotel. Lunch/ Snacks at nearby cafes. Dinner as possible following discussions. Meals: Admission: Prime Minister - Leo Varadkar will be in attendance over the course of the 3-day program Leader of the Opposition - Micheal Martin (Fianna Fail politician) will also be in attendance over the course of the 3-day program Other important attendees are the other speakers listed in the attached agenda. All public guests who attend have to RSVP for each event they attend at this link: https://stmichaelsnewross.ticketsolve.com/shows/873608384 Other (please list): Total: Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the Employee signature: XII person providing the reimbursement, waiver or payment. Date: 10.7.19 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. . KENNEDY SUMMER SCHOOL A FESTIVAL of IRISH & AMERICAN HISTORY, CULTURE and POLITICS ******** ******** ******** <<<<<<<<<<<<<<<<<<<<<<<<< ......... ......... 5th / 6th / 7th of SEPTEMBER 2019 NEW ROSS, CO. WEXFORD, IRELAND. www.kennedysummerschool.ie WELCOME It is with tremendous pleasure that we invite you to join us in New Ross for the 2019 Kennedy Summer School. The Summer School has become a major cultural event and diary commitment for the first full weekend of each September; Larry Donnelly and as summer draws to a close, people on both sides of the Atlantic sharpen their focus on the year ahead. Over three days - from the 5th to the 7th of September - we will be joined by high profile figures from the United States, Ireland, and beyond to discuss our shared history and culture, our politics in a time of uncertainty and tumult, and what our Dr Robert M. Mauro future may hold in store. Of course, we will once again be discussing the Trump presidency as the 2020 election looms in the US, as well as the impact Brexit will have on the whole of this island, the United Kingdom, and beyond. The Summer School will commence with the commemorative Tea Party and with the dedication and accession of the Larkin Collection to the Kennedy Book and Research Archive at New Ross Library. We will have a number of expert panels discussing history, religion, sport, US politics, Irish politics, and more. There will be entertainment including our annual speakers lunch, our Kennedy Summer School Tea Party and numerous occasions for lively informal encounters. As our keynote speakers this year, we are especially honoured to welcome Most Reverend Eamon Martin, Archbishop of Armagh, Primate of All Ireland, New York Times columnist Maureen Dowd and former US Congressman Bruce Morrison. It is worth repeating: there will literally be something for everyone at the Kennedy Summer School on the first weekend in September. We hope that you will join with us and our organising committee for some or all of what promises to be an informative, thought provoking, and enjoyable three days in New Ross. Larry Donnelly, Dr Robert M. Mauro, Co-Directors of the Kennedy Summer School 2019 The Kennedy Summer School Programme is subject to change. For up to date details and full profiles of speakers see kennedysummerschool.ie kennedysummerschool.ie 5th - 7th September 2019 2"
008e3567b62110ec01d31692c64e779cc25fd202ea374a3d1f4a27dc3636eebb,2014/golar_Richie_Charlotte_Disc..pdf,2014,2014 Charlotte Golar Richie SEP 24,,,"THE COMMONWEALTH OF MASSACHUSETTS ENSE COMMISSION AGAINST DISGRIMINATION: RECEIVED SION OVIETEM COMMISSION time PETIT ONE ASHBURTON PLACE, BOSTON. MA 02108- 15183 2014 OCT tiil AGAINST DISCRIMINATORY Deval L. Patrick Jamie R. Williamson Governor Chairwoman October 17, 2014 Sunila Thomas George Commissioner Charlotte Golar Richie Commissioner Lauren E. Duca Deputy Chief/SFI, Legal Division State Ethics Commission One Ashburton, Room 619 Boston, MA 02108 Dear Ms. Duca: Please find enclosed my resubmitted signed and dated disclosure form. Thank you, Commissioner Tel: (617) 994-6000 TTY: (617) 994-6196 Fax: (617) 994-6024 DISCLOSURE BY SPECIAL STATE EMPLOYEE 20-14-5500 RECEIVED OF FINANCIAL INTEREST IN A STATE CONTRACT STATE ETHICS AS REQUIRED BY G. L. C. 268A, § 03 THIS Name of special state employee: 2014 SPECIAL Charlotte STATE EMPLOYEE Golar INFORMATION Richie SEP 24 PM 4: 03 I am a special state employee because: Put an X beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state agency or by the terms of a contract or my conditions of employment, I 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 state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Incoming Vice Chair of umass Boston's Centerfor External Advisory Board for If you are a special state employee because women a state agency in has Politics contracted with Public your company Policy or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. (CWPPP) N/A State Agency/ This is ""my State Agency."" Department: umass/Boston, Center for Women in Politics R Agency Address: University of Massachusetts, Boston Public Policy Boston, MA 02125 100 momssey Blvd 10th fl, Rm 12 Office phone: 617-287-5541 Office e-mail: Check one: Elected or Non-elected Starting date as a special state I joined the External Advisory Board of CWPPR employee. as a Member in 1999? BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee Select either N/A STATEMENT #1 or STATEMENT #1: I had a financial interest in a contract made by a state agency before I was STATEMENT #2. elected to a compensated special state employee position. I will continue to have this financial interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an X A compensated, non-elected position with a state agency. by your financial interest. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). Select either STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an STATEMENT #1 or employment contract, before I took a non-elected, compensated special state employee position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an X by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the ""contracting agency."" Name and address of state agency that made the contract (MCAD) Mass Commission Against Discrimination One Ashburton Place, Room 601 Boston, MA 02108 Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. MCAD ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX Commissioner of the MCAD"
009bf73bb7fed5774c2092482497158a234fba4c4397839eda1a612b347ec8b1,"2017/Stanley,_Thomas_6.27.17_-_6A.pdf",2017,,,,"The Commonwealth ofMassachusetts ENSB 1 HOUSE OF REPRESENTATIVES PRETTY STATE HOUSE, BOSTON, MA 02133-1054 LIBERTATE LEVE VICE CHAIR, JOINT COMMITTEE ON MUNICIPALITIES AND REGIONAL GOVERNMENT THOMAS M. STANLEY JOINT COMMITTEE ON WAYS AND MEANS STATE REPRESENTATIVE JOINT COMMITTEE ON REVENUE 9TH MIDDLESEX DISTRICT HOUSE COMMITTEE ON POST AUDIT AND OVERSIGHT Thomas.Stanley@MAhouse.gov ROOM 167, STATE HOUSE BOSTON, MA 02133 TEL: (617) 722-2230 June 27, 2017 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Dear Commissioners: I am writing to you to disclose that my wife and I own property on Cape Cod which we rent as a vacation home through HomeAway, an online vacation rental marketplace. The Joint Committee on Financial Services, of which I am a member, is considering legislation which would impact the short-term rental market. If adopted, this legislation may have an effect on my financial interests which is different from the effect on the general public. I anticipate that in this session and in future sessions of the General Court, legislation relative to this interest may be considered. I make this disclosure pursuant to G.L. c. 268A, §§6A & 23(b)(3) and consider it public in nature. Thomas THOMAS Sincerely State"
00a37a0da6c480e2666fb4309e7ca02dfa401db66c69e4ed5952acb7edc75d33,"2018/Tietjen,_Jeanie_10.3.18.pdf",2018,JEANIE TIETJEN,,32 GND MASSBAY COMMUNITY College in Post Sealy Edvanted,"DISCLOSURE BY NON-ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)1. NON-ELECTED PUBLIC EMPLOYEE INFORMATION Name of non-elected public employee: JEANIE TIETJEN 2018 OCT -3 Title/ Position Professon of ENgliSH STATE THICS COMMISS GND RECEIVED PM 12: 32 32 Agency/ Department MASSBAY COMMUNITY College in Post Sealy Edvanted Agency address: 50 OAKLANd St Wellesley HILLS, MA 02/55 Office phone: 7812392203 Office e-mail: I am filing this disclosure because: itietjen e MASSBAY. edu Write an X to confirm I am going to engage in an activity that serves a legitimate public purpose, i.e., it is each statement. intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for ASKeD TO present AT SUNY COMM College traveling. Affand officers os tRAUMA -INFOrmed CONFERENCE for COMM college chief student Describe your practices Relevant to higher educa Time. participation in the activity. Delivery presentATion 4 informety discussion ON TRAUMA PRACTICES. Date, time and location of activity. 10/4/18 QreNSBurg, NY Please explain how the activity will promote the interests of the MASSBAY is the fast commany college TO UNPERTAKE Commonwealth, a county or a municipality. services IN whys THAT the designl to pedryogy 0 be relevent To THE whole NATURAL Shaning provices d collasonary w/ottens benefits All. TRAVEL EXPENSES Identify the person or organization that offered to reimburse, Sevin Vice President Stubs Engagement Julie White, PhD waive or pay your travel expenses. t Leaning Support ONANdAgA Carn College Address of person or organization. Syramse, NY Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: REVIAL CAn to UBeRs To/from RENTAL site $250 gAS + Lodging: Overnight Overnight Breakfast, accommodations. lunch, dinner, / QueensBy special events. Ny Sleep /NW & Suites $200 Meals: WeD diNNer, Thu breakfast + Lunch $ 100 $ Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): hANdars, prepartin time, PRESeNDATIW WRIT Research $200 t Total: $750 Write an X beside I have attached the relevant itinerary. any statement that applies. Employee signature: Date: Jun I have attached the relevant agenda. 10/1/18 Attach additional pages if necessary. Complete the disclosure and submit it to your appointing authority. - ATTACING flyer defing OR Carn for Transa — ATTACH Brtef STATEMET of summy fn presentant t Leong N Post Se cooldry EducAION DETERMINATION BY APPOINTING AUTHORITY APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Agency and Title/Position: Agency address: Office phone: Employee who filed the disclosure: DETERMINATION Upon consideration of the facts disclosed by the employee above, I find that: To give approval, Acceptance of the reimbursement, waiver or payment of travel expenses will serve a check both legitimate public purpose, i.e., it will promote the interests of the Commonwealth, a county or a municipality; AND statements. Such public purpose outweighs any special non-work related benefit to the employee or the person providing the reimbursement, waiver or payment. Reason that the employee's travel or attendance will serve a legitimate public purpose: Appointing Authority signature: Date: Attach additional pages if necessary. The appointing authority should maintain the disclosure as a public record and give a copy of any signed determination to the employee. Wednesday, October 03, 2018 3:00 pm Arrive Queensbury Hotel, Glens Falls, NY www.thequeensburyhotel.com 5:30 pm to 7:00 pm Evening Reception and Dinner, Queensbury Hotel 7:00-8:00 pm John Graham and Nazely Kurkjian, SUNY Update Thursday, October 04, 2018 7:30-8:45 Breakfast at Queensbury Hotel 8:45-9 Shuttle to SUNY Adirondack 9-9:15 Welcome (Julie White) 9:15-11 Becoming a Trauma-Informed Campus, (Dr. Jeanie Tietjen, Center for Trauma & Learning in Post-Secondary Education), MassBay Community College 11-11:15 Break 11:15-11:45 ALICE Protocol for Emergency Response (Kim Irland, North Country Community College) 11:45-12:45 Lunch (Well Connect) 12:45-1:45 Responding to Student Deaths: Case Study (Rebecca Hoda-Kearse, Onondaga Community College) 1:45 to 2:45 Hot Topics roundtable 2:45 to 3:00 Break 3:00 to 3:45 SUNY SA presentation/Student Government Best Practices (Mike Braun, SUNY SA President) 3:45 to 4:15 Rev Up New Student Orientation (Jane Kelley, Fulton Montgomery Community College) 4:15 to 4:45 Campus Tour 4:45 Shuttle to hotel 6:30 to 9:00 Dinner at Morgan and Company, Glens Falls (across from the hotel) Friday, October 05, 2018 8:00 am to 9:00 am Breakfast, Queensbury Hotel 9:00 am to 11:30 am Business Meeting, Queensbury Hotel 11:30 am Announcements and Updates Noon Adjourn"
00a4cb147614d28ab2f4b27a6a01977447a15c490b084360f86f23255afc1ce8,2012/Gayle_Cameron(1).pdf,2012,Gayle Cameron,,Office of the Attorney General,"THE COMMONWEALTH OF MASSACHUSETTS ENSE PETIT OVIETEM OFFICE OF THE ATTORNEY GENERAL ONE ASHBURTON PLACE BOSTON, MASSACHUSETTS 02108 MARTHA COAKLEY (617) 727-2200 ATTORNEY GENERAL www.mass.gov/ago June 26, 2012 Karen Nober Executive Director State Ethics Commission One Ashburton Place Boston, MA 02108 Re: Disclosure by Gaming Commissioner Gayle Cameron Dear Ms. Nober: Enclosed is the Disclosure by Non-Elected Employee of Financial Interest and Determination by Appointing Authority as Required by G.L. c. 268A, § 6. If you have any questions, please contact me. Thank you. Very truly yours Judy Zeprun Kalman Deputy General Counsel cc: Gayle Cameron, Gaming Commissioner 2012 JUN 27 AM AM 10:33 33 DIS SINWOO SOMES GIVIS RECEIVED DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE ETHICS RECEIVED COMMISSIO STATE EMPLOYEE INFORMATION Name: 2012 JUN 27 AM 10: 33 Gayle Cameron Title or Position: Commissioner State Agency: Massachusetts Gaming Commission Agency Address: 84 State Street, Suite 720 Boston, MA 02109 Office Phone: 617-979-9400 Office E-mail: Gayle.cameron@sate.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other Pursuant to Chapter 194 of the Acts of 2011 and G.L. c. 23K, the Massachusetts Gaming proceeding, application, Commission (the ""Commission"") is authorized/or required to promulgate rules, regulations, submission, request for a ruling or other policies, and procedures and to make determinations concerning the compensation and benefits determination, contract, provided to the Commission's employees, a code of ethics governing employees' activities and claim, controversy, investments, the licensing and oversight of potential gaming establishments within the charge, accusation, Commonwealth, the host and surrounding communities that may experience impacts from the arrest, decision, determination, or finding. development or operation of a gaming establishment. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: As a Commissioner, I and my fellow commissioners are charged with official responsibility for all matters within the Commission's jurisdiction, including the Particular Matters described above. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter Within the scope of my Required Participation in the Particular Matters described above, I will be required to participate in operational and regulatory determinations that will or may affect my reasonably foreseeable financial interests or those of my immediate family. Specifically, the Commission will be developing employment policies and an enhanced code of ethics that may affect the financial interests of its employees, including the Commissioners, as to employee benefits, health and life insurance, vacation, retirement benefits, and permissible investments. Employee signature: Date: Bayle 6-7-12 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Martha Coakley Title or Position: Attorney General Agency/Department: Office of the Attorney General Agency Address: One Ashburton Place Boston, MA 02108 Office Phone: 617-727-2200 Office E-mail ago@stagte.me DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Indy Dephing Jonen General Calman, counsel Date: Comment: the 6.26.12 ""particular matter is mandated not so by Selsstantial that t pay be deemed likely Statnile The funan wal interest t bosfect-the integrity of services Attach additional pages if recessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108"
00a99dfe5a9155fb1fed77b09a7407ace0aeef85986adb9b3a44a835a9865f08,"2021/Fowler,_Mary_8.6.2021_-_CMR_6.08(2).pdf",2021,Mary Fowler,,,"DISCLOSURE BY STATE EMPLOYEE OF A FINANCIAL INTEREST IN A CONTRACT TO PROVIDE SERVECEIVED COMMISSION FOR THE COMMITTEE FOR PUBLIC COUNSEL SERVICES AS REQUIRED BY 930 CMR 6.06(2) 2021 AUG AMII:21 21 STATE EMPLOYEE INFORMATION Name of state Mary Fowler employee: Title/ Position Please provide information about your state employee position. Professor Agency: Worcester State University Agency address: 486 Chandler Street Worcester, MA 01602 Office phone: 508-929-8576 Office e-mail: mfowler@worcester.edu I am a state employee. The Committee for Public Counsel Services (""CPCS"") provides representation and services to persons with regard to various matters in the state courts and assigns attorneys and personnel to work on the matters. In connection with these matters, I expect to provide representation or services to, or on behalf of, such persons, attomeys or personnel. I respectfully request written approval of the arrangement from CPCS and (if I am not an elected state employee) from my appointing authority in my state position. CPCS SERVICES Describe the nature of the representation or services you expect to Statistical expert testimony in defense of provide to or for Obed Zorrilla CPCS. with Attorney Elleen Morrison If you are providing services through a company, please Racial Equity Partners, LLC provide its name and address, Who will pay you for your services? CPCS, directly. An attorney or personnel assigned by CPCS. If not CPCS, please provide the name and address of the person or entity who will pay you or your company for your services. What is your financial Please explain your financial interest and provide the dollar amount if you know it. interest in providing these services? I am being contracted to provide statistical analysis which might include writing a report and giving testimony. Please include both compensation and The court allowed a motion for $2,500. Depending on what is found in the data analysis, the obligations, etc. project could further require additional funds. 1 approximate the additional funds could be as high as $10,000. Employee signature: APPROVAL BY COMMITTEE FOR PUBLIC COUNSEL SERVICES Name and title of CPCS employee giving approval Attorney Eileen Morrison Office phone 978-458-7161 Office e-mail emorrison@publiccounsel.net Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed CPCS employee, above and approve the arrangement proposed by the state employee. EileerLn Date: 7-8-21 FOR NON-ELECTED STATE EMPLOYEES ONLY: APPROVAL BY APPOINTING AUTHORITY AT STATE AGENCY WHICH YOU SERVE Name and title of appointing authority, or Linda Larrivee his or her designee, at Dean School of Education, Health and Natural Science the state agency which you serve Office phone 508-929-8333 Office e-mail ilarrivee@worcester.edu Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed appointing authority above and approve the arrangement proposed by the state employee. Date: 8/4/2021 Attach additional pages if necessary. File copy with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised March, 2013"
00abe309829f9ab540f3bfe9209640e026a2b5b36477970c25933cadc3394fb8,"2023/Payano,_Pavel._1.9.23_-_CMR_5.08(2)(d)2.pdf",2023,Pavel Payano,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected Pavel Payano public employee: Title/ Position State Senator Agency/ Department Massachusetts Senate Agency address: 24 Beacon St. Room 222 Boston, MA 02133 Office phone: 617-722-1604 Office e-mail: Pavel.payano@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. ______ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _________________________ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I will be joining other Massachusetts legislative officials in traveling to San Miguel, traveling. Azores, and Lisbon, Portugal, to meet with Portuguese and United States officials and discuss issues of importance to Portugal and Massachusetts, including economic development, educational partnerships, maritime security, and green energy initiatives. Describe your participation in the I will meet with Portuguese and United States officials to discuss these issues of activity. mutual interest. Date, time and location January 9 - 17, 2023 of activity. San Miguel, Azores (January 9 - 13) Lisbon, Portugal (January 13 - 17) I will be attending this trip from January 9 to 17, 2023. Please explain how the Massachusetts is home to a large Portuguese-American community, and there are activity will promote the significant economic, cultural, educational, and other issues of mutual interest to interests of the Portugal and Massachusetts. Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or organization that The Luso-American Development Foundation (FLAD) will be paying for in-country offered to reimburse, ground transportation as listed below. waive or pay your travel expenses. The municipality of Ponta Delgada will be paying for some ground transportation and a meal as listed below. I will be personally paying for the costs of my flights, accommodations, and meals except as otherwise indicated below. The amounts listed below reflect estimates of costs that are close to but not $50 or more. For any incidental hospitality listed in the itinerary that is not indicated below, I have determined at this time that any such incidental hospitality is not close to nor will be $50 or more. Address of person or organization. FLAD Rua Sacramento à Lapa, 21 1249-090 Lisbon, Portugal The Municipality of Ponta Delgada Praca da Republica 9504-523 Ponta Delgada, Portugal Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: FLAD is covering in-country ground transportation up to a total of €675.00 ($716.94) for the entire group. With 23 legislative officials on this trip. the per person amount covered by FLAD will be €29.35 ($31.24). The municipality of Ponta Delgada is covering ground transportation within the municipality up to a total of €280.80 ($298.21) for the entire group. With 23 legislative officials on this trip, the per person amount covered by the municipality will be €12.21 ($13.00). Overnight accommodations. Lodging: Breakfast, lunch, dinner, special events. Meals: The municipality of Ponta Delgada will be paying for a meal for a total cost of €720.00 ($764.65) for the entire group. With 23 legislative officials on this trip, the per person amount covered by the municipality will be €31.30 ($33.31). Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): FLAD: €29.35 ($31.24) Total: The Municipality of Ponta Delgada: €43.51 ($46.31) Write an X beside any I have attached the relevant itinerary. relevant statement. 1 have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND Having disclosed the facts above, I determine that: For the exemption X Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. X Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
00af14052db99c1d66016ce6fd71792d9957e5572e48058693cb7f7a3744219d,"2020/Kurland,_Jacquie_Corrected_Dis._3.17.2020_6.pdf",2020,Jacquie Kurland,,Chancellor's Office,"University of RECEIVED Massachusetts STATE ETHICS COMMISSION Office of the Chancellor Amherst 2020 MAR 17 PM 2: 13 March 12, 2020 Legal Division State Ethics Commission One Ashburton Place Boston, MA 02108 RE: Disclosure under M.G.L. Chapter 268A, Section 6 Dear Sir/Madam: Pursuant to M.G.L. Chapter 268A, Section 6, I enclose the following documents for filing with the Ethics Commission as required under the statute: 1. Disclosure of Financial Interest form and Memorandum, dated February 13, 2020, from Associate Professor Jacquie Kurland to request permission to extend appointment of her spouse, Polly Stokes, as a part-time (8 hours/week) Speech Language Pathologist/Lab Manager for an additional 12-month period of bridge funding (March 22, 2020 - March 21, 2021) pursuant to her recently awarded Faculty Research Grant. 2. My letter of determination, dated March 12, 2020, which permits Associate Professor Jacquie Kurland to extend appointment of her spouse, Polly Stokes, as a part-time (8 hours/week) Speech Language Pathologist/Lab Manager for an additional 12-month period of bridge funding (March 22, 2020 - March 21, 2021) pursuant to her recently awarded Faculty Research Grant. Very truly yours, KUSunnamy Kumble R. Subbaswamy Chancellor Enclosures University of Massachusetts 374 Whitmore Administration Building, 181 Presidents Drive Amherst, MA 01003-9313 413.545.2211 fax: 413.545.2328 www.umass.edu DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Jacquie Kurland Title or Position: Associate Professor State Agency: University of Massachusetts Amherst Agency Address: Dept. of Communication Disorders 358 North Pleasant Street 2020 MAR 17 PM 2: 14 STATE ETHICS COMMISSION RECEIVED Amherst, MA 01003 Office Phone: (413) 545-4007 Office E-mail: jkurland@comdis.umass.edu My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other This disclosure is in the matter of re-appointing my spouse to fulfill the role of part-time Speech proceeding, application, Language Pathologist/Lab Manager in my research laboratory. Please see copy of attached letter submission, request to UMass Amherst Chancellor Subbaswamy. for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: I am the principal investigator on the research studies performed in the lab. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter Fifty-two weeks hourly (8 hours/week through March 21, 2021) un-benefitted salary: $ 12,866,88 Employee signature: Junnie bullane Date: 2/13/20 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Kumble R. Subbaswamy Authority: Title or Position: Chancellor Agency/Department: Chancellor's Office Agency Address: University of Massachusetts - Amherst 374 Whitmore Administration Building Amherst, MA 01003 Office Phone: (413) 545-2211 Office E-mail chancellor@umass.edu DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: 3/12/2020 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 University of School of Public Health & Health Massachusetts Sciences Amherst Department of Communication Disorders February 13, 2020 Re: Disclosure and Compliance with Conflict of Interest Law on Spousal Hire for Part-time Speech Language Pathologist / Lab Manager (Kurland, PI) Dear Chancellor Subbaswamy, I am writing to request your approval in compliance with the Conflict of Interest Law on Spousal Hire, so that I may continue to fill a key personnel position in my lab. The extension I am requesting is for a period of bridge funding (March 22, 2020 - March 21, 2021) to re- appoint my spouse, Polly Stokes (M.S., CCC-SLP) to a part-time (8 hours/week) position of Speech Language Pathologist/Lab Manager (currently classified in HR as Department Assistant). I will pay for this position from General Operating Funds that I received, mostly in compensation for participating on the MSP Contract Negotiations team. This bridge funding will allow my Speech Language Pathologist (SLP), who currently serves as both clinician and lab manager, to continue to assist me with grant proposal preparation, as well as to complete Phase 2 (post-treatment testing) of a two-phase pilot study award I received from a Faculty Research Grant that expires in May 2020. In the interest of avoiding any appearance of conflict of interest, Dr. Karen Helfer (Professor, Communication Disorders), has agreed to be the supervisor of record. Over the last 8 years, in accordance with the UMass Nepotism Policy, I have obtained the support of my Chair and the Dean of SPHHS, as well as your determination that I could proceed with the hire and re-appointment and UMass has filed the appropriate Disclosure Form with the State Ethics Commission. Since your last letter of determination allowed for another seven months re-appointment through March 22, 2020, which was all I had funding to cover at that time, I am now again seeking approvals from my Chair, my Dean, and from you. For your information, over the last period since reappointing Polly, we have been working hard on developing a test of transactional success in conversation in post-stroke aphasia. Thanks to the FRG award this year, we completed acquisition of the first phase of testing data, i.e., collection of story retellings from 96 neurotypical controls. Polly has recently completed pre-treatment testing of a cohort of participants with aphasia, the first half of the second phase of the FRG-funded study, ""A Valid, Reliable, Clinically Feasible Measure of Transactional Success in Aphasic Conversation"". These two datasets are being transcribed and analyzed, and will be used as pilot data for an R01 proposal to be submitted in October 2020 to NIH, "" Validating the Brief Assessment of Transactional Success (BATS): A Clinically Feasible Measure"
00bd3b53101b96b3f74e2677d21f6cf00b78a397941e4d88a78c4fc47bbf8c83,2015/NunnellyMark_2.pdf,2015,Mark Nunnelly,,Governor's Office,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINA NCIAL INTEREST AND DETERMINATION BY APPOIN TING AUTHORITY AS REQUIRED BY G. Ltd. 268A, STATE EMPLOYEE INFORMATION 2015 MAY 22 § 6 PM12: 40 Name: Mark Nunnelly Title or Position: Commissioner of Department of Revenue (""DOR"") Special Advisor for Technology Investment and Competitiveness (""Special Advisor"") State Agency: Administration & Finance/(DOR) Governor's Office (Special Advisor) Agency Address: 100 Cambridge Street Boston, MA 02114 Office Phone: 617-626-2201 Office E-mail: nunnellym@dor:state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other proceeding, application. submission, request Changes in the tax code including regulatory and statutory changes, increase/reduce capital gains, for a ruling or other revenue collections, tax credits, tax deductions, tax filing system, review and comment on proposed determination, contract, regulations, review technology systems, and customer service initiatives. claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: E.g., approval, As Commissioner of DOR I will need to review, recommend/disapprove and approve: changes in the disapproval, decision, tax code including regulatory and statutory changes, increase/reduce capital gains, revenue recommendation, collections, tax credits, tax deductions, tax filing system, review and comment on proposed rendering advice, regulations, review technology systems, and customer service initiatives. investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter I serve as the Chief Investment Officer and also serve on the Investment Committee for the Dupre-Nunnelly Family Office. I currently serve as a director of the following boards: BMC Software, Inc., Dunkin' Brands Group, Inc. and Genpact Limited. I plan to transition off the BMC Software Board of Directors during 2015. I am a member of many LLC's including ones that hold investments, real estate and real property. These entities and my family are subject to taxes (eg., income, excise, capital gains, corporate excise tax, etc.). Employee signature: Date: March 25, 2015 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Governor Charles D. Baker Title or Position: Governor of the Commonwealth of Massachusetts Agency/Department: Governor's Office Agency Address: State House Room 360 Boston, MA 02133 Office Phone: 617-725-4005 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Chanby D Bab Charles D. Baker, Governor Date: Comment: Commissioner Nunnelly should seek my further determination if his professional responsibilities and participation in a particular matter at any time are anticipated to have a greater effect on his financial interests and/or those of his family or an organization for which he serves as an officer, director, trustee, partner or employee than on the financial interests of other state employees or the general public. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
00c0ba652b96a66aaa1f92fb670b84fda85b7a193a717e08f07e6b04d30a7661,"2017/McGee,_Thomas_930CMR5.082d2_disclosure_11.28.17.pdf",2017,Thomas M. McGee,,Massachusetts State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. STATE ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected 2017 NOV 28 PM 2:16 public employee: Thomas M. McGee Title/ Position State Senator Agency/ Department Massachusetts State Senate Agency address: State House Boston, MA 02133 Office phone: 617-722-1350 Office e-mail: Thomas.mcgee@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. _X_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _X_ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity I have been invited to participate in a seminar on Transition and Leadership for Newly which is the reason for Elected Mayors. This is collaboration every two years by Harvard Kennedy School's traveling. Institute of Politics and the U.S. Conference of Mayors. Describe your participation in the As the mayor-elect, I will participate in intensive seminars on major urban policy issues activity. such as public safety, municipal finance, and crisis management, led by prominent scholars and practitioners representing viewpoints from across the political spectrum Date, time and location Tuesday, November 28-Thursday, November 30, 2017 of activity. Two locations for the seminar: The Charles Hotel and the Kennedy Institute of Politics Please explain how the I will participate in intensive seminars on major urban policy issues such as public activity will promote the safety, municipal finance, and crisis management, led by prominent scholars and interests of the practitioners representing viewpoints from across the political spectrum. I will attend Commonwealth, a county workshops that help new mayors take on the practical challenges of urban or a municipality. governance. TRAVEL EXPENSES Identify the person or organization that Christian Flynn offered to reimburse, Director, Conferences and Special Projects waive or pay your Institute of Politics travel expenses. Harvard Kennedy School Address of person or organization. 79 John F. Kennedy Street Cambridge, MA 02138 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: N/A Overnight accommodations. Lodging: $589.80 Breakfast, lunch, dinner, special events. Meals: $550.00 Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): Tote bag and water bottle $28.00 Total: $1,167.80 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the providing the reimbursement, waiver or payment. Employee signature: Date: 11-27-17 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 8 a D HARVARD Kennedy School INSTITUTE OF POLITICS Seminar on Transition for Newly Elected Mayors November 28-30, 2017 Tuesday, November 28, 2017 4:30 p.m. RECEPTION Noir, The Charles Hotel 5:40 p.m. WALK TO HARVARD KENNEDY SCHOOL 6:00 p.m. CITIES AS LABORATORIES FOR INNOVATION: WHAT THE COUNTRY CAN LEARN John F. Kennedy Jr. Forum, Harvard Kennedy School The Honorable Peter Buttigieg, Mayor, South Bend, IN The Honorable Sly James, Mayor, Kansas City, MO; Visiting Fellow, Institute of Politics The Honorable Martin Walsh, Mayor, Boston, MA The Honorable Sharon Weston Broome, Mayor, Baton Rouge, LA Jorrit de Jong (moderator), Faculty Director of the Bloomberg Harvard City Leadership Initiative This event will be open to the entire Harvard Community. 7:00 p.m. RECEPTION WITH HARVARD STUDENTS John F. Kennedy Jr. Forum, Harvard Kennedy School 8:00 p.m. OPENING DINNER Malkin Penthouse, Littauer Building, Harvard Kennedy School Hosted by: The Honorable Bill Delahunt, Acting Director, Institute of Politics Tom Cochran, CEO and Executive Director, U.S. Conference of Mayors SELF INTRODUCTIONS Mayors will be asked to introduce themselves and speak briefly of immediate challenges they are facing."
00ccb43d526d4f670e7c87d63b2e8725238b0d8156da633e0a2240cb4db2a81f,2023/Madison_Eric_10.20.23_7(b).pdf,2023,Eric H. Madison,,"Department of Fire Services, Mass Firefighting Academy","DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING AGENCY AS REQUIRED BY G. L. c. 268A, § 7(b) STATE EMPLOYEE INFORMATION Name of state Eric H. Madison employee: Title/ Position Fire Instructor I If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Agency/ Department Department of Fire Services, Mass Firefighting Academy Agency Address 1 State Road PO Box 1025 Stow, MA 01775 Office phone: 978-567-3100 Office e-mail: N/A Check one: Elected or Non-elected Starting date as a October 24, 2023 state employee. ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. STATEMENT #1: I had one of the following financial interests in a contract made by a state Select either agency before I was elected to my compensated state employee position. I will continue to STATEMENT #1 or have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an X My financial interest in a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. STATEMENT # 1: I had one of the following financial interests in a contract made by a state Select either STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to have this financial interest in a state contract. STATEMENT #2. Write an X My financial interest in a state contract is: beside your financial interest. A state agency has a contract with me, but not an employment contract. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. -- OR -- STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest in a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address of state agency that Massachusetts Registry of Motor Vehicles PO Box 55889 made the contract Boston, MA 02205 ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an My State Agency is not the contracting agency. to confirm these facts. My State Agency does not regulate the activities of the contracting agency. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. FILL IN - Please explain what the contract is for. THIS BOX OR THE BOX BELOW ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. FILL IN - Please identify the person or entity that has the contract with the state agency. - What is your relationship to the person or entity? THIS BOX - What is the contract for? OR THE BOX The contract is between the Registry of Motor Vehicles and the National Safety Council to ABOVE provide various Defensive Driving training courses to those individuals directed to take such courses either by the Registry of Motor Vehicles or a Court in the Commonwealth. I am a paid"
00d3886121784809ec81f1d9bf70ce7aa498cf8fe544f2a63b486db4b46869be,"2014/Hindle,_Lori_section_6_disclosure_2014-10-16.pdf",2014,Lori Hindle,,EXECUTIVE OFFICE FOR ADMINISTRATION AND FINANCE,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Lori Hindle Title or Position: Director of Intergovernmental Affairs State Agency: Executive Office for Administration and Finance Agency Address: State House Room 373 Office Phone: 617-727-2040 Office E-mail: Lori.hindle@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. I interact w/ MassDevelopment w/ respect to the following matters: E.g., a judicial or other TEFRAs - administrative review of eligibility for tax-exempt borrowing by private entities. proceeding, application, volume cap - administrative review of eligibility for tax-exempt borrowing by private entities submission, request I-cubed financings - structure debt for economic development projects pursuant to Ch 293 of Acts for a ruling or other of 2006. determination, contract, board member *** act as back up designee for Secretary's ex officio seat claim, controversy, 100 Cambridge St - review swap termination options on the existing financing charge, accusation, arrest, decision, open checkbook - liaison for on boarding MassDevelopment in the state's system determination, or finding. moral obligation bonds - administrative review of proposed financings pursuant to 801 CMR 56.00 State FInance and Governance Board - review qualified conduit debt transactions on behalf of board, recommend review and/or approval of certain matters described in the regulations I am interviewing w/ MassDevelopment for the Infrastructure and Governmental Finance Specialist Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: Review for adherence to laws and regulations of TEFRA and volume cap transactions. E.g., approval, Provide results of review to the Governor and Secretary. Review for adherence to disapproval, decision, recommendation, regulations qualified conduit debt transactions on behalf of Finance and Governance Board, rendering advice, investigation, other. and review and/or approval by the board of certain matters described in the regulations and, advice on other topics FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial Interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. 1 am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial Interest and include a dollar amount if you know lt. In the matter MassDere copment receives various feed in connection with transactions. Employee signature: Lortuidle Date: 10/14/14 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: GLEN SHOR Title or Position: SECRETARY Agency/Department: EXECUTIVE OFFICE FOR ADMINISTRATION AND FINANCE Agency Address: STATE HOUSE, ROOM 373 Office Phone: 617-727-2040 Office E-mail GLEN.SHOR@STATE.MA.US DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest Identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the Integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Mrs Date: 10/16/14 Comment: 1 ASSIGN ACC MASS DEVELOPMENT MATTERS IN WHICH (ORI HINDLE WOULD ORDINARILY PARTICIPATE to UNDERSECRETARY SOOT JORDANOR HIS DESIGNEE, EXCEPT THOSE ROUTINE MATTERS IN WHICH UNDERSECRETARY JORDAN DETERMINES MS. HINDLE MAY CONTINUE TO PARTICIPATE. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
00dd0b89ca237cb15a2422560454141d911b08d4d3c0fa042c0fb2d46ece2190,2023/Liqin_Ouyang_3.8.23_-_7(b).pdf,2023,LIQIN OUYANG,,,"DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING AGENCY AS REQUIRED BY G. L. C. 268A, § 7(b) STATE EMPLOYEE INFORMATION Name of state employee: LIQIN OUYANG Title/ Position Senior Applications Developer If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Agency/ Department Agency Address Office phone: Office e-mail: Check one: Elected or Non-elected Starting date as a 11/16/2009 state employee. ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. STATEMENT #1: I had one of the following financial interests in a contract made by a state Select either agency before I was elected to my compensated state employee position. I will continue to STATEMENT #1 or have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an X My financial interest in a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. Select either STATEMENT # 1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a state contract is: Write an X beside your A state agency has a contract with me, but not an employment contract. financial interest. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. -- OR -- STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest in a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address of state agency that Community Economic Development Assistance Corporation (CEDAC) made the contract 18 Tremont Street, Suite 500, Boston, Massachusetts ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an X My State Agency is not the contracting agency. to confirm My State Agency does not regulate the activities of the contracting agency. these facts. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. (Please see attached letter from CEDAC) ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. - Please explain what the contract is for. FILL IN I will provide web development technical support for the existing WordPress infrastructure THIS BOX OR THE BOX of CEDAC, as well as those of its affiliate, the Children's Investment Fund (CIF). BELOW http://www.cedac.org/ http://www.cedac.org/cif (www.childrensinvestmentfundma.org) ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. FILL IN - Please identify the person or entity that has the contract with the state agency. THIS BOX - What is your relationship to the person or entity? OR THE BOX - What is the contract for? ABOVE What is your - Please explain the financial interest and include the dollar amount if you know it. financial interest In the state contract? I have a contract with CEDAC for total funds up to $14,112.50. I will invoice CEDAC monthly, itemizing time spent, dates of services and brief description of services. I will be paid $50 per hour, based on approved invoices and documentation of services provided. Date when you acquired a financial As of today (03/07/2023), I am still in the process to get my paperwork ready, so I have interest not acquired a payment yet. What is the financial - Please explain the financial interest and include the dollar amount if you know it. interest of your immediate family? None Date when your None immediate family acquired a financial interest FOR A CONTRACT FOR PERSONAL SERVICES - Answer the questions in this box ONLY if you will have a contract for personal Write an X services with a state agency (i.e., you will do work directly for the contracting to confirm each agency). statement. I will have a contract with a state agency to provide personal services."
00f295da7eef771518d7eaaddb64f142c4b385843c756519079c3627380bd236,"2017/Flanagan,_Jennifer_5.24.17_-_CMR_5.08(2)(d)2.pdf",2017,Jennifer L. Flanagan,,Massachusetts Legislature,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. STATE ETHICS RECEIVED COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected 2017 HAY 24 PM 3:22 public employee: Jennifer L. Flanagan Title/ Position Massachusetts State Senator Agency/ Department Massachusetts Legislature Agency address: The Statehouse Beacon St. Room 312D Boston, MA 02133 Office phone: 617-722-1230 Office e-mail: jennifer.flanagan@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. XX I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and XX A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I will be attending the National Council of Legislators from Gaming States (NCLGS) traveling. 2017 Summer Meeting in Denver, CO. Describe your I will attend meetings, listen to presentations on responsible gaming, internet gaming, participation in the lotteries, learn about state and federal regulations on these subject as well as activity. emerging forms of gaming. Date, time and location June 9-11 2017 of activity. June 9, 2017- 8:AM start June 11, 2017 10:30AM end The Westin Denver Downtown 1672 Lawrence St. Denver, CO 80202 Please explain how the As the senate point person on legalized gaming in Massachusetts, it is my activity will promote the responsibility to connect, share and learn all that I can on this issue. This is an interests of the opportunity to share information and ideas from legislators from across the United Commonwealth, a county States. I will bring the lessons I learn back to my senate and house colleagues and to or a municipality. the citizens I represent. I am hopeful that the legislature will make more informed decisions on these issues. TRAVEL EXPENSES Identify the person or National Council of Legislators from Gaming States (NCLGS) organization that 1201 New Road, Suite 308 offered to reimburse, Linwood, New Jersey 08221 waive or pay your Wayne Marlin Vice President Government Affairs travel expenses. Address of person or organization. Same as above Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: United Airlines $590.00 Overnight accommodations. Lodging: 3 nights lodging @$179.00 per night plus 14.75% tax $537.00 plus tax $79.21 = $616.21 TOTAL Breakfast, lunch, dinner, special events. Meals: N/A Registration, admission, tickets, etc. Admission: $375.00 waived. Refreshment, instruction, materials, entertainment, etc. Other (please list): N/A Total: $1581.21 Write an X beside any XX I have attached the relevant itinerary. relevant statement. XX I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption XX Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. XX Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: May 23, 2017 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 Ryan, Tillie (SEN) From: Jen Flanagan <jen@jenflanagan.com> Sent: Monday, May 22, 2017 1:37 PM To: Ryan, Tillie (SEN) Subject: Fwd: Your United reservation for Denver, CO, US (DEN) is processing Here is the information for my flight to Denver. Let me know if you need anything else. Forwarded message From: United Airlines, Inc. <unitedairlines@united.com> Date: Mon, May 22, 2017 at 1:35 PM Subject: Your United reservation for Denver, CO, US (DEN) is processing airfore To: jen@jenflanagan.com reservation Add UnitedAirlines@news.united.com to your address book. See instructions. Monday, May 22, 2017 Thank you for choosing United We're processing your reservation and will send you an eTicket Itinerary and Receipt email once completed. This process usually takes less than an hour, but in rare cases it could take longer. If you don't receive an eTicket Itinerary and Receipt email within 24 hours, please call the United Customer Contact Center Confirmation number: C65RRR Boston, MA, US (BOS) to Denver, CO, US (DEN) Manage reservation Purchase summary 1 adult (18-64) $514.42 Taxes and fees $75.58 Total $590.00 Credit card payment: $590.00 (MasterCard-**7122) 1"
01042cdeed57e385005a796f5b67e33f5fb2ed2a3499809b69a65d9c4c5f9be2,"2019/Levine,_Amanda_10.18.19_-_6.pdf",2019,Amanda Levine,,FW Parker Charter Essential School,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Amanda Levine Title or Position: Spanish Domain Leader and Teacher State Agency: FW Parker Charter Essential School Agency Address: 49 Antietam St., Devens, MA 01434 Office Phone: 978.772.3293 Office E-mail: mlevine@theparkerschool.org My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other Contract with travel company for a field trip to Mexico with students. proceeding, application, submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: I was one of the individuals who selected the travel company, Interact Travel, to contract E.g., approval, with to organize a trip with students to Mérida, Mexico, in April of 2020. disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter As a person who will also go on this trip as a chaperone with my students, I will not pay for this trip. Cost of chaperones is included in the student price. Interact has no rewards programs for teachers, except for discounts for immediate family members to go on the trip as well. None of my family will be coming with me on this trip. Employee signature: amath Date: 61/51/01 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Todd Sumner Authority: Title or Position: Principal Agency/Department: FW Parker Charter Essential School Agency Address: 49 Antietam St., Devens, MA Office Phone: 978-772-3293 Office E-mail tsumner@theparkerschool.org DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: dlls Date: 15 OCTOBER 2019 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
010d2abeab8aed92b688a439d0edd37a544c3c28abe0d8a10fc483c28e7752cf,"2019/Rodrigues,_Michael_930CMR5.082d2_disclosure_5.23.19.pdf",2019,Michael J. Rodrigues,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. RECEIVED ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Michael J. Rodrigues 2019 MAY 23 PH 2:09 Title/ Position Chair, Senate Ways and Means Committee Agency/ Department Massachusetts Senate Agency address: 24 Beacon Street, Boston, MA 02133 Office phone: 617-722-1114 Office e-mail: Michael.Rodrigues@masenate.gov. Write an X to confirm I I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for Travel to Lisbon, Portugal to join elected political leaders to participate in the traveling. Luso-American Legislators Dialogue. This meeting brings together Portuguese and Portuguese-American elected officials. Describe your participation in the Meeting with Fundacao Luso-Americana, (FLAD) President Rita Faden, activity. George Glass, United States Ambassador, Vasco Cordeiro, President of the Azores Pedro Siza Vieira, Minister in the Cabinet of the Prime Minister and of Economy Francisco Seixas da Costa, Ambassador Paulo Portas, former Deputy Prime Minister Rui Rio, President of the Social Democratic Party Marcelo Rebelo de Sousa, President of the Portuguese Republic Date, time and location of activity. May 30 and May 31, 2019, Lisbon, Portugal Please explain how the activity will promote the This activity will promote the bilateral relationship between the United States and interests of the Portugal Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or organization that Rita Faden, President offered to reimburse, Fundacao Luso-Americana, FLAD waive or pay your travel expenses. Address of person or organization. Rua do Sacramento a Lapa, 21 1249-090 Lisboa, Portugal Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Airlines: SATA Internacional Flight $1255.84 Transportation, approx. $67.20 per person Overnight accommodations. Lodging: Tivoli Avenida Liberdade Lisboa Av. da Liberdade 185, 1269-050 Lisboa + 351 21 319 8900 4 nights - - May 29 to June 1, 2019 $1344.00 Breakfast, lunch, dinner, special events. Meals: 4 Meals Approx. $134.40 per person Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: Approx. $ 2801.44 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: Mulul 5/33/19 And Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 zo fundação LUSO-AMERICAN LEGISLATORS' LUSO-AMERICANA DIALOGUE PARA O DESENVOLVIMENTO V LEGISLATORS' DIALOGUE PROGRAM I May 30 - 31 Thursday, May 30 02:10pm Delegation arrival 02:30pm Welcome by Rita Faden, president of FLAD George Glass, USA Ambassador to Portugal 03:00pm Working Session Topic: The Future of the Portuguese-American Communities 04:15pm Break 04:30pm Session: Leonor Beleza, president of Champalimaud Foundation Topic: The experience of the Champalimaud Foundation Manuel Heitor, Minister of Science, Technology and Higher Education Topic: The Science in Portugal 06:00pm Session: Topic: Portugal today Rui Rio, president of the Social Democratic Party 08:00pm Dinner: Gambrinus Friday. May 31 08:30am Breakfast hosted by the US Ambassador to Portugal, George Glass, in his residence 10:15am Session Topic: Portuguese private companies' potential on a global economy Rodrigo Costa, Chairman & CEO, REN - Redes Energéticas Nacionais, SGPS, S.A. 11:15am Break 11:30am Session Topic: Azores role in bilateral relationship with the US Vasco Cordeiro, president of the Azores 01:00pm Lunch Topic: Perspectives for the future of the Portuguese Economy Keynote speaker: Pedro Siza Vieira, Minister in the Cabinet of the Prime Minister and of Economy 03:30pm Session Topic: A Portuguese perspective of the Transatlantic Relations Francisco Seixas da Costa, Ambassador Paulo Portas, former Deputy Prime Minister 05:00pm Break 06:00pm Closing session Marcelo Rebelo de Sousa, President of the Portuguese Republic 07:30pm Closing dinner Keynote speaker: Elvira Fortunato, scientist and member of the Board of Trustees of FLAD"
0115fbd0e3c58628879484e40b2100a9d25f37e1ed3c4ef7e1e29f673b003dce,"2025/Gillen,_Michele_section_6_disclosure_4.18.25.pdf",2025,Michele Gillen,,,"WATER RESOURCES MASSACHUSETTS WATER RESOURCES AUTHORITY Deer Island 33 Tafts Avenue STATE MASSACHUSETTS Boston, MA 02128 2025 APR 18 AM 10: 17 Frederick A. Laskey Telephone: (617) 242-6000 Executive Director Fax: (617) 788-4899 TTY: (617) 788-4971 April 14, 2025 State Ethics Commission One Ashburton Place, Room 619 Boston, Massachusetts 02108 Re: MWRA - Disclosures/Determinations Under M.G.L. C. 268A Dear Sir or Madam: Enclosed for filing, please find copies of executed disclosure forms pursuant to the provisions of M.G.L. C. 268A, §6, for Frederick Laskey, Executive Director; Carolyn Francisco Murphy, General Counsel; Michele Gillen, Director, Administration; and Wendy Chu, Director, Human Resources, disclosing potential financial interests regarding a review of employee benefits and potential recommendations for changes to policies and practices concerning employee benefits, along with the requisite Appointing Authorities' determinations approving the aforementioned employees' participation in the disclosed actions. Thank you for your attention to this matter. Please do not hesitate to contact me should you have any questions concerning the enclosed disclosure forms. Sincerely, Kimberly A Whenon Kimberley A. McMahon Associate General Counsel Kimberley.McMahon@mwra.com Enclosures DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Michele Gillen Title or Position: Director, Administration State Agency: Massachusetts Water Resources Authority Agency Address: 33 Tafts Avenue, Boston, MA 02128 Office Phone: 617-788-2550 Office E-mail: Michele.Gillen@mwra.com My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter To review benefits provided to employees under collective bargaining agreements and determine whether additional benefits should be provided to non-union managers. The benefits under review E.g., a judicial or other for such determination include: (1) vacation leave, (2) sick leave, (3) personal leave, (4) proceeding, application, bereavement leave, (5) skeleton days, (6) shift differential, (7) standby/on-call pay, (8) overtime, (9) submission, request compensatory time, (10) meal stipend, (11) longevity pay, (12) sick leave buyback, and (13) tuition for a ruling or other reimbursement. It is anticipated that such review will result in a recommendation to the MWRA determination, contract, Board of Directors to add benefits provided to non-union managers that are provided to unionized claim, controversy, charge, accusation, employees under collective bargaining agreements. arrest, decision, determination, or finding. Your required To work with senior management and staff in the Human Resources Department, Law Division and participation in the Finance Division, to compare and contrast the benefits provided to non-union managers with particular matter: benefits provided to employees under collective bargaining agreements. After reviewing the similarities and differences between such benefits, I anticipate that I will be involved in discussions E.g., approval, with senior managers to determine whether to recommend to the Board of Directors that additional disapproval, decision, benefits be provided to non-union managers. I anticipate assisting in making such determination. If recommendation, the determination is made to recommend to the Board of Directors that additional benefits be rendering advice, provided to non-union managers, my participation will also include preparing materials for and investigation, other. making a presentation to the Board of Directors for such recommendation and, if approved by the Board of Directors, amending the Holiday, Vacation & Leave Policies and Procedures for non-union managers. I may also be involved with implementation of changes as needed. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest If the aforementioned project results in a recommendation to amend the policy, and/or the Board of in the matter Directors votes to amend the policy, the amendments may result in greater benefits for non-union positions, including my position. Employee signature: Muhel s Biller Date: 03/26/2025 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Frederick Laskey Authority: Title or Position: Executive Director Agency/Department: Massachusetts Water Resources Authority Agency Address: 33 Tafts Avenue, Boston, MA 02128 Office Phone: 617-788-1101 Office E-mail Fred.Laskey@mwra.com DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: 3/31/2025 70.00 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
011c3b414b09d5d877efbe7b687d496ae67f5f0b5944af3ea9bdd9c53c77803a,2022/Owusu_Michael_11.15.22_7(b).pdf,2022,Michael OWOSU,,DMH,"DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING AGENCY RECEIVED AS REQUIRED BY G. L. c. 268A, § 7(b) STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION 2022 NOV 14 PM 12:47 Name of state employee: Michael OWOSU Title/ Position Mintal health worker If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Agency/ Department DMH Agency Address worcester Recovery Center and Hospital 309 Belmontst. Workster ma 01609 Office phone: Office e-mail: michael.Y.owusu.@mass.gov Check one: Elected or Non-elected Starting date as a state employee. 10/24/22 ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. STATEMENT #1: I had one of the following financial interests in a contract made by a state Select either agency before I was elected to my compensated state employee position. I will continue to STATEMENT #1 or have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an X My financial interest in a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and 1 am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. Select either STATEMENT # 1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to have this financial interest in a state contract. STATEMENT #2. Write an X My financial interest in a state contract is: beside your financial interest. A state agency has a contract with me, but not an employment contract. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. - OR -- STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest in a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address UMASS Chan MC dicalschool of state agency that made the contract SSNILaKe Ave. worcester ma 01655 ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an X My State Agency is not the contracting agency. to confirm these facts. My State Agency does not regulate the activities of the contracting agency. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. FILL IN - Please explain what the contract is for. THIS BOX TO provide direct caic services toa OR THE BOX highly psychiatrically an behaviorally BELOW compro MISC d ado rescent population, including forensics, I am particularly skilled ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. this with FILL IN - Please identify the person or entity that has the contract with the state agency. popila FIOR - What is your relationship to the person or entity? THIS BOX - What is the contract for? OR THE BOX UMASS Chan medicalschoo / ABOVE direct care per diem staff member FOR CONTRACTS FOR PERSONAL SERVICES ONLY:"
0123d823c927138b6153f5b5b1fd7e6105de61944a25a0159d008febf6c032be,"2015/Giroux,_Melissa_12.28.15.pdf",2015,melissa GiRoux,,Department of TRUNSITIONAL Assistance,"DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST RECEIVED IN A CONTRACT TO PROVIDE SOCIAL SERVICES TATE ETHICS COMMISSION PURSUANT TO 930 CMR 6.07 2015 DEC 28 AM IO: 23 STATE EMPLOYEE INFORMATION Name of state employee: melissa GiRoux Title/ Position: Benefits eligibility Referred Societ worker ( ) ) Agency/Department: Department of TRUNSITIONAL Assistance Agency Address: 95 Linerty St springfieu) MA 01103 Office phone: (413)858-1032 Office e-mail melisa.GIROGY@MUSSMaiL.StaTe.MA.US I am a state employee, and I seek to have a financial interest in a contract or agreement made by a state agency listed below, or by a provider or organization funded by a state agency listed below: A state agency within the following Executive Offices: Executive Office of Health and Human Services, including the Human Service Transportation Office: Executive Office of Public Safety and Security. Executive Office of Elder Affairs, Executive Office of Veteran's Services, or A sheriff's office. The purpose of the contract is: To provide personal services to a person or persons who receive services from, or have services paid for by, these stale agencies: or To provide educational services lo people who work for these state agencies or for providers or organizations funded by these state agencies. I seek approval of the arrangement from the agency for which I serve as a state employee and from the state agency above that made the contract. FINANCIAL INTEREST IN A CONTRACT WITH A STATE AGENCY PLEASE CHECK OFF ONE OF THE THREE STATEMENTS BELOW AND PROVIDE THE REQUESTED INFORMATION. 1) Service to a state agency I will provide personal or educational services to a state agency listed above. Please identify the state agency and also the Executive Office it is in, if applicable. 2) Service to a provider or I will provide personal or educational services to a provider or organization funded by a state organization agency listed above. Please provide the name and address of the provider or organization. Please identify the state agency that funds the provider or organization, and also the Executive Office it is in, if applicable. 3) Service to a person or persons I will provide personal services directly to a person or persons who receive services from, or have services paid for by. a state agency listed above. Please identify the state agency that provides services to, or pays for services for, the person or persons, and also the Executive Office it Is in, if applicable. MassHealTH Please describe the Please provide information about the type of personal or educational services you will provide. services you will Please do not Include the name of any Individual who receives services. provide. I am a THeRapist at west cerinal family & counseling - - 103 Myken st, west springfield, MA 01089. I previde psycho - THeRapy TO patients. Psycitatherapy is What will you be paid, or what other Please include a dollar amount, if possible. often funders by State OR private INSURance companies. financial interest will you have? paiD TU west central Emily & counseling (MASSHealtH OR Meijirake) Payment is Employee signature Meliser GUNY Date: 11-14-15 APPROVAL BY AGENCY YOU SERVE AS A STATE EMPLOYEE Name and title of appointing authority THOMAS G. MASSIMO Office phone 617 - 348 - 8493 Office e-mail THOMAS.MASSIMO@STATE.MA.US Signature by By signing here, I indicate that I have reviewed the facts that the state employee has appointing authority disclosed above and approve the arrangement proposed by the state employee. a Date: 12/4/15 APPROVAL BY AGENCY THAT MADE THE CONTRACT (IF DIFFERENT) Name and title of person giving approval at the state Amarda Cassel Kraft, chief of staff agency that made the contract Office phone 617-593-1738 Office e-mail anaunda.casselkraft@statena.us Signature by person By signing here, 1 indicate that 1 have reviewed the facts that the state employee has giving approval disclosed above and approve the arrangement proposed by the state employee. Amade Carl Katt Date: 12/14/15 Attach additional pages if necessary. File with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012"
013348ad3e67cbcad302492898a4ff37185c438503ed98678b9282077ac86677,"2020/Low,_Jeffrey_Tyler_2.27.2020_6.pdf",2020,Jeffrey Tyler Low,,,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY CUMM. AS REQUIRED BY G. L.c. 268A, § 6 2020 FEB 27 AM 10: 34 STATE EMPLOYEE INFORMATION Name: Jeffrey Tyler Low Title or Position: Head Mer's LACrosse Coach State Agency: Umass BOSTON Athletics Agency Address: Clark Athletic Center, 100 Morrissey Blvd, Baston, MA 02125 Office Phone: 617-287-7886 Office E-mail: Tyler.Low@cmB.edu. My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other My Brother, spencer Low, would be paid proceeding, application, as an Assistant lacrosse Coach here at submission, request for a ruling or other determination, contract, Umais BOSTON. claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: / am the head mens lacrosse coach E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. nancial interest Please explain the financial interest and include a dollar amount if you know it. I the matter spencer Low would be compensated $ 1,000 Employee signature: Date: J 2/19/20 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Title or Position: Agency/Department: Agency Address: Office Phone: Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, 1 have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Charli Files Date: Comment: 2/20/20 Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
01346ce52db65d754df25519d9f46dc3b73bb9b75b6b71389a3e8cd76d74f3d0,"2021/Theoharides,_Kathleen_section_6_disclosure_11.1.21.pdf",2021,Kathleen Theoharides,,Office of the Governor,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 STATE EMPLOYEE INFORMATION Name: Kathleen Theoharides Title or Position: Secretary of Energy and Environmental Affairs State Agency: Executive Office of Energy and Environmental Affairs Agency Address: 100 Cambridge St. Suite 900 Boston, MA 02114 Office Phone: 617-626-1000 Office E-mail: Kathleen.theoharides@mass.gov. My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter As part of the FY2022 budget, the Legislature appropriated $13,539,987 ""[f]or the operation of the office of the secretary of energy and environmental affairs provided further, that not less than E.g., a judicial or other $1,000,000 shall be expended to provide grants to non-profit organizations to support offshore wind proceeding, application, innovation and ecosystem acceleration and to support pilot studies or prototyping in offshore wind submission, request innovation in partnership with public higher education institutions or marine science non-profit for a ruling or other organizations = The particular matter in which my duties require me to participate is the determination, contract, disposition of this earmark. EOEEA has not yet determined which non-profit organizations, if any, claim, controversy, should receive grants under this earmark or decided on a process to make that determination. charge, accusation, arrest, decision, Greentown Labs, Inc. has requested ""$750,000 (as earmarked in the Office of the EOEEA determination, or finding. Secretary's line item 2000-0100) to support the formation, launch and initial programming associated with the Offshore Innovation Initiative."" This proposal seeks to ""(1) identify and deploy the innovative solutions needed to support [offshore wind] industry growth; and (2) engage key stakeholders in the clean energy ecosystem and environmental community in the development of these innovations."" Your required Greentown Labs has made this request of the Executive Office of Energy and Environmental Affairs, participation in the of which I am the Secretary. particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest I have no personal or familial financial interest in this matter. However, by virtue of my service as in the matter Secretary of EOEEA, I am also the chair of the board of the Massachusetts Clean Energy Center (""MassCEC""). Pursuant to a loan agreement in which MassCEC loaned money to Greentown Labs, MassCEC is empowered to designate a member of Greentown Labs' board of directors. I am the MassCEC designated board member of Greentown Labs. Greentown Labs has a financial interest in this matter in the amount of $750,000. Employee signature: K.Theoharides Date: 10/13/2021 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Charles D. Baker Authority: Title or Position: Governor Agency/Department: Office of the Governor Agency Address: Massachusetts State House Boston, MA 02133 Office Phone: Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Charles D. Baker Title or Position: Governor of the Commonwealth of Massachusetts Agency/Department: Office of the Governor Agency Address: State House Room 360 Boston, MA 02133 Office Phone: (617) 725-4000 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Charbs D Baw Date: Comment: I am assigning this particular matter to Judy Chang, EOEEA Undersecretary of Energy. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0137f934069d73e0c1ae9d659957a94d644b0e46395cc4a8e7a566c012f17f36,"2018/Pirelli,_Nicholas_9.21.18_-_7(d).pdf",2018,Nicholas R Pirelli,,,"DISCLOSURE BY SPECIAL STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT ECEIVED AS REQUIRED BY G. L. c. 268A, § 7(d) Expenses IMMISSION SPECIAL STATE EMPLOYEE INFORMATION 2018 SEF 21 PH L: 04 Name of special Nicholas R Pirelli state employee: I am a special state employee because: Put an beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state 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 state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position State University Instructor If you are a special state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. State Agency/ This is ""my State Agency."" Department: Bridgewater State University Agency Address: 131 Summer Street Bridgewater, MA 02325 Office phone: 508-531-1442 Office e-mail: n1pirelli@bridgew.edu Check one: Elected or Non-elected Starting date as a September 1, 2018 special state employee. BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee. Select either STATEMENT #1 or STATEMENT #1: I had a financial interest in a contract made by a state agency before I was elected to a compensated special state employee position. I will continue to have this financial STATEMENT #2. interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an A compensated, non-elected position with a state agency. by your financial A contract between a state agency and myself. interest. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). Select either STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an STATEMENT #1 or employment contract, before I took a non-elected, compensated special state employee position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the ""contracting agency."" Name and address Greenfield Community College of state agency that 1 College Drive made the contract Greenfield, MA 01301 Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX 1 will be working as Special Assistant to the President for Strategic Initiatives"
013946004810a3069dba73d9c3b584d192b65cb519d622f0da1e69202531ab3d,"2016/Spilka,_Karen_930CMR5.082d2_disclosure_12.9.16.pdf",2016,Karen E. Spilka,,"Senate, Senate Committee on Ways and Means","DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ETHICS RECEIVED COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION2016 DEC -9 PM 2:46 Name of elected public employee: Karen E. Spilka Title/ Position Massachusetts Senator Agency/ Department Senate, Senate Committee on Ways and Means Agency address: Room 212 State House Boston, MA 02133 Office phone: 617.722.1640 Office e-mail: Karen.Spilka@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. _X_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _X_ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for traveling. The Millbank Memorial Fund has arranged a two day symposium in Minneapolis on the subject of health care cost, quality and delivery. Presenters from the fields of government and public health will share lessons learned from Minnesota's efforts in the areas of health care payment and delivery system reform. Describe your participation in the activity. I will attend and participate in discussions regarding Minnesota's health care cost containment efforts and their applicability to similar efforts in the commonwealth. Date, time and location of activity. December 14 - 16, 2016 Commons Hotel 615 Washington Avenue SE Minneapolis, MN Please explain how the activity will promote the This trip will inform our work in the senate as we consider the next steps to take in interests of the health care cost containment policy. Minnesota is of particular interest to our work, Commonwealth, a county given its experience with controlling costs and improving care delivery in the areas of or a municipality. managed care, behavioral health, and long term services and supports. These same areas have substantial impact on health care costs in the commonwealth, and on the MassHealth program in particular. TRAVEL EXPENSES Identify the person or organization that offered to reimburse, Millbank Memorial Fund waive or pay your travel expenses. Address of person or organization. 645 Madison Ave., 15th Floor New York, NY 10022 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: $615 (flight and ground transportation) Overnight accommodations. Lodging: $270 - 2 nights at the Commons Hotel Breakfast, lunch, dinner, special events. Meals: Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. _X_ Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Karen E. Spilka Date: December 9 , 2016 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 State Massachusetts Research and Analysis of Policy Issues Related to Payment and Delivery System Reforms A Technical Assistance Meeting Sponsored by the Milbank Memorial Fund The Commons Hotel, Minneapolis, Minnesota December 15-16, 2016 AGENDA Thursday, December 15 9:00 A.M. Welcome and Introductions James Welch, Massachusetts Senate Trina A. Gonzalez, Program Officer, Milbank Memorial Fund 9:15 Medicaid Initiatives and Reforms: Minnesota and Massachusetts Lynn Blewett Director, State Health Data and Assistance Center and Professor, Health Policy and Management, University of Minnesota Dr. Blewett will provide an overview of Medicaid initiatives in Minnesota and Massachusetts. Dr. Blewett conducts research on the factors affecting health insurance coverage and access to and use of health care as these factors relate to state health policy. In addition to her roles with SHADAC and the University, Dr. Blewett directs the State Health Access Reform Evaluation, a Robert Wood Johnson Foundation national program that funds and evaluates health reform at the state level. 10:30 Community Paramedicine and Scope of Practice Issues in Minnesota: Lessons Learned Buck McAlpin Partner Libby Law Offices Community Paramedicine Background - context and political environment Program implementation, financing and oversight Scope of practice issues Background - context and political environment Specific issues targeted in Minnesota Buck McAlpin Mr. McAlpin has worked in the health care arena for over 20 years, starting as a 1"
0139756a38f318d448e03fccfec7637c1c3510a4c8cd2f1eb24a2746893776fe,2012/skarinKathleen6.7.19(2).pdf,2012,Kathleen Skarin,,Middlesex Sheriff's Office,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL AND DETERMINATION AS REQUIRED BY BY APPOINTING G. L.c. 268A, AUTHORITYE § 6 ANTHICST COMMISSION STATE EMPLOYEE INFORMATION 2012 JUL 19 AM 9:47 Name: Kathleen Skarin Title or Position: Chief of Staff State Agency: Middlesex Sheriff's Office Agency Address: 400 Mystic Avenue Medford, MA 02155 Office Phone: 781-960-2800 Office E-mail: kgskarin@sdm.state.ma.us My duties require me to participate in a particular matter, and 1 may not participate because of a financial interest that 1 am disclosing here. I request a determination from my appointing authority about how 1 should proceed. PARTICULAR MATTER Particular matter E.g., a judicial or other proceeding, application, Decision about an increase in salary for at-will employees. submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required participation in the particular matter: As the Chief of Staff, I am required to participate in matters relating to employee salaries. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. __X_ I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement conceming future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Because I am an at-will employee, my salary will be impacted by the decision. It is likely in the matter that the increase in my salary will be less than $1,300. Employee signature: Date: Kathleng 6/28/2012 Skann DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Peter J. Koutoujian Title or Position: Middlesex Sheriff Agency/Department: Middlesex Sheriff's Office Agency Address: 400 Mystic Avenue Medford, MA 02155 Office Phone: 781-960-2800 Office E-mail Pjkoutoujian@sdm.state.ma.us DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: R Date: 6/28/2012 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
014c43af8f043ef99ad5576833dd868820df2b83892ad13f72c77b032ba37daa,"2017/Rodrigues,_Michael_4.13.17_-_CMR_5.08(2)(d)2.pdf",2017,Michael J. Rodrigues 2017 APR 13 PM 3: 44,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. RECEIVED ELECTED PUBLIC EMPLOYEE INFORMATION ATE ETHICS COMMISSION Name of elected public employee: Michael J. Rodrigues 2017 APR 13 PM 3: 44 Title/ Position Majority Whip State Senate Agency/ Department Massachusetts Senate Agency address: 24 Beacon Street, Boston, MA 02133 Office phone: 617-722-1114 Office e-mail: Michael.Rodrigues@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for Travel to Lisbon, Portugal to join elected political leaders to participate in third edition traveling. of the Luso-American Legislators Dialogue. This meeting brings together Portuguese and Portuguese-American elected officials. Describe your participation in the Meeting with Fundacao Luso-Americana, (FLAD) President Vasco Rato, Herro activity. Mustafa, Deputy Chief of Mission of the USA Embassy in Portugal, Minister of Sea, Ana Paula Vitorino, Minister of Culture, Luís Filipe de Castro Mendes, Pedro Passos Coelho, President of the Social Democratic Party, Robert A. Sherman, Former U.S. Ambassador in Portugal, and Ângelo Ramalho, CEO of EFACEC, Eduardo Cabrita, Minister Assistant, Rui Moreira, Mayor of Porto, and Maria do Céu Albuquerque, Mayor of Abrantes, Marcelo Rebelo de Sousa, President of the Portuguese Republic, Jorge Sampaio, Former President of Portugal Date, time and location of activity. April 21-24, 2017, Lisbon, Portugal Please explain how the activity will promote the This activity will promote the bilateral relationship between the United States and interests of the Portugal Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or organization that Vasco Rato, President offered to reimburse, Fundacao Luso-Americana, FLAD waive or pay your travel expenses. Address of person or organization. Rua do Sacramento a Lapa, 21 1249-090 Lisboa, Portugal Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Airlines: TAP Air Portugal Flight $842.62 Transportation, approx. $63.59 per person Overnight accommodations. Lodging: Hotel Dom Pedro Lisboa Av. Eng. Duarte Pacheco 24, 1070-110 Lisboa, Portugal 3 Night April 21 to April 23, 2017 $ 508.75 Breakfast, lunch, dinner, special events. Meals: 3 Meals Approx. $127.19 per person Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: Approx. $ 1,542.15 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Unhal by Date: 4/12/17 Attach additional pages if necessary. Elected state or county employees file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 FUNDAÇÃO LUSO-AMERICANA Vasco Rato Presidente do Conselho Executivo The Honorable Michael Rodrigues US State Senator State House - Room 2138 Boston Massachusetts 02133 USA Proj° 84 /2017 Lisboa, 10th March, 2017 Dear Senator Michael Rodrigues, As you know, in 2015 and 2016 FLAD held its annual Luso-American Legislators' Dialogue, bringing together Portuguese and American elected officials of Portuguese heritage. I would now like to invite you to participate in the III Luso-American Legislators' Dialogue. Your participation in this event is of the utmost importance and, of course, FLAD will cover your travel and lodging expenses. This event will take place on April 21 and 22, 2017 and we would be honored if you could accept this invitation. With my best regards, VRt VR/MV /163- 2017 FUNDAÇÃO LUSO-AMERICANA PARA O DESENVOLVIMENTO Rua do Sacramento à Lapa, 21 I 1249-090 Lisboa ! Portugal TEL. [+351] 21 393 58 00 FAX [+351] 21 396 33 58 e-mail: fladport@flad.pt TRAVEL Bilhete Electrónico We make good deals for you Electronic Ticket Agencia de Viagens / Travel Agency TRAVEL GATE, SA."
014f5bb93f8a1c9b5b21c5d7f17d0299bb7490856b31c91d109fa3ab0490a6cf,2014/ConroyThomas_10.10.14.pdf,2014,Thomas P. Conroy,,Massachusetts Legislature,"DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. C. 268A, § 23(b)(3) RECEIVEDMISSION Name: Thomas P. Conroy STATE ETHICS Title or Position: State Representative 2014 OCT 10 PM 3:03 Agency/Department: Massachusetts Legislature Agency address: The State House Boston MA 02133 Office Phone: 617-722-2014 Office E-mail: Thomas.conroy@mahouse.gov I am expected to perform my official duties as a state, county, or municipal employee, and I have a relationship or affiliation with a person or organization involved. I am filing this disclosure to dispel the appearance that the person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I would be likely to act or fail to act as a result of kinship, rank, position or undue influence of any party or person. Describe the issue that is coming before Any particular legislative matter on which the Massachusetts Taxpayers Foundation has you for decision or taken a publicly-announced position or point of view. action. What responsibility do you have for State Representative taking action or making a decision? Describe your relationship or I have applied for a job at the Massachusetts Taxpayers Foundation and am actively affiliation with pursuing it. someone involved. Optional: Facts indicating there is no need for concern about undue favoritism or improper influence. Write an X to confirm & Taking into account the relationship or affiliation that I have disclosed above, I feel this statement. Employee signature: 70mm that I can perform my official duties objectively and fairly. Date: 9/30/14 Ninal, awended 10/9/14 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
01589986b00b7a8f9165e09e2f3ae08f204857686c40dd7f5675e0027680f3aa,"2018/Pavlos,_Carlene_1.22.18_-_6.pdf",2018,Carlene Pavlos,,DPH,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY RECEIVED AS REQUIRED BY G. L. c. 268A, § 6 STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION 2018 JAH 22 PH 1: 15 Name: Carlene Pavlos Title or Position: Director, Bureau of Community Health and Prevention State Agency: Massachusetts Department of Public Health Agency Address: 250 Washington Street, 5th Floor, Boston, MA 02108 Office Phone: 617 624 5491 Office E-mail: Carlene.pavlos@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other I am the Bureau Director for Community Health and Prevention which interacts with the proceeding, application, Massachusetts Public Health Association in a variety of ways. For the purposes of this disclosure, submission, request the most important of these is that we provide MPHA with a contract of approximately $100,000 for a ruling or other through the Preventive Health and Health Services Block Grant. I have been contacted about determination, contract, claim, controversy, applying for the position of Executive Director of the MPHA and will be exploring this opportunity. charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: As the Bureau Director, I oversee the manager of the Preventive Health and Health E.g., approval, Services Block Grant and the manager who oversees the MPHA contract. I am involved disapproval, decision, in multiple conversations with MPHA staff on a variety of public health issues which recommendation, overlap with the scope of the Bureau and their contract supports public health capacity- rendering advice, building across the state. Should concerns with the current contract arise, I would play a investigation, other. key decision-making role in what actions should be taken by the Department. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter As previously noted, MPHA is has a contract with DPH's Bureau of Community Health and Prevention and this places me in a position of making key decisions regarding this funding. Their grant award is approximately $100,000 for this fiscal year and is anticipated to be approximately the same next fiscal year. Employee signature: Date: 11/8/17 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Undsey Tucker Title or Position: Associate Commissioner Agency/Department: DPH Agency Address: 250 Wishington St Boston Office Phone: 617.624.5200 Office E-mail lindsey.tncker@stae.ma.us DETERMINATION Determination by As appointing official, as required by G.L. c. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. I Write an X am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: 1/19/18 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
0164ac86f8b57fa1d87f38f88e52cbe0a67167677a0a1b413bb386e7739a7b42,2022/Hawley-Inacio_Theresa_8.15.22_-_7(d).pdf,2022,Theresa TheresaHawley-Inacid Hawley 2022 AUG 15 AH AM10: 53,,,"DISCLOSURE BY SPECIAL STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AS REQUIRED BY G. L. C. 268A, § 7(d) SPECIAL STATE EMPLOYEE INFORMATION STATE ETHICS RECEIVED COMMISSION Name of special state employee: Theresa TheresaHawley-Inacid Hawley 2022 AUG 15 AH AM10: 53 I am a special state employee because: Put an X beside one I serve in a state position for which no compensation is provided. statement. 1 am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state 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. 1 work for a company or organization which has a contract with a state agency, and 1 am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Assistant professor of Nursing at Springfield Technical Community College (position ending this month /August 2022) If you are a special state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. State Agency/ This is ""my State Agency."" Department: springfield Technical community Colles Armory Square Springfield MA Agency Address: / Armory Square springfield MA 01105 Office phone: 413 781 7822 HR: 413-755-4489 Office e-mail: trhawleyinacib@stre.edu If tjlove abol@stec.edu Check one: Elected or Non-elected Starting date as a Iam leaving the STCC faculty position to work at Western special state employee. Mass Hospital this month la state DPH facility). the transition day should be simultaneous/ immodiate. Iam working at the BOX # 1 ELECTED SPECIAL STATE EMPLOYEE hospital starting 8/13/2 TRU I am an elected special state employee. Select either STATEMENT #1: I had a financial interest in a contract made by a state agency before I was STATEMENT #1 or elected to a compensated special state employee position. I will continue to have this financial STATEMENT #2. interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an X A compensated, non-elected position with a state agency. by your financial A contract between a state agency and myself. interest. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an Select either employment contract, before I took a non-elected, compensated special state employee STATEMENT #1 or position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an X by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address of state agency that position at Western Mass Hosp ital as After I start that This is the ""contracting agency."" I will be starting a 3a hR staff nurse made the contract job, I will be parttime ladjunct clinical faculty are day weekly atSTCC. Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX I am finishing my 2021-2022 academic year facutes posotion contract for STC Call work wa completed may- payment is Spread out over a calovdar September to August I year. am starting a new staff wmtt."
01755f1ceb305b35b3abe2d1e1d22bf41d572831748310a01c6f9c89059abde8,"2017/Puppolo,_Jr.,_Angelo.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. c. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public Angelo J. Puppolo, Jr. official: Public official State Representative position: Public office State House, Room 236 address: Boston, MA 02133 Office Phone: 617-722-2430 Office E-mail: Angelo.puppolo@mahouse.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. 1 understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action The General Court intends to consider the issue of compensation adjustments for certain to be taken: public officials, including constitutional officers and legislators. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial Interest and Include the dollar amount if you know it. involved: As a committee member and as a state representative from Springfield, my compensation may be adjusted. Public official's signature: Adamy Date: 1/23/2017 Attach additional pages If necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
017dc4fb928cbf2c6ccfaa89abd5e8940dcd48f981eb974eae152285960cf520,"2019/Lovely,_Joan_B._930CMR5.082d2_Disclosure_6.17.19.pdf",2019,Joan B. Lovely,,Massachusetts State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. DATE ED ETHICS COMMISSIC ELECTED PUBLIC EMPLOYEE INFORMATION 2019 JUN / PB 2: 40 Name of elected Joan B. Lovely public employee: Title/ Position Senator Agency/ Department Massachusetts State Senate Agency address: State House, Room 413-A Boston, MA 02133 Office phone: (617) 722-1410 Office e-mail: Joan.lovely@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. _X_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _X_ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I was invited and agreed to serve on the ""Interventions to Save Lives"" subcommittee traveling. for the CSG Healthy States National Task Force. I will travel to Lexington, Kentucky for the first meeting of this subcommittee. Describe your participation in the I will be serving as a member of the subcommittee and attending workshops and activity. events offered as part of the subcommittee meeting. Date, time and location of activity. June 17, 2019 June 19, 2019, Hyatt Regency Lexington, 401 West High Street Lexington, KY 40507 Please explain how the activity will promote the The subcommittee will be exploring emerging policy and best practices in the field of interests of the preventive health and medicine. As a member, I will have the opportunity to learn Commonwealth, a county or a municipality. from other legislators and policy specialists from around the country and bring that knowledge back to Massachusetts to share with the Senate and legislature as we continue to work on these issues. TRAVEL EXPENSES Identify the person or organization that The Council of State Governments offered to reimburse, waive or pay your travel expenses. Address of person or 1776 Avenue of the States organization. Lexington, KY 40511 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Overnight accommodations. Lodging: $224 ($112/night x2 nights) Breakfast, lunch, dinner, special events. Meals: Day 1: Evening reception Day 2: Breakfast, lunch included Day 3: Breakfast included Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: $224 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: Jan Attach 6/14/19 additional Raver pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 CSG Healthy States: What Works? A CSG National Task Force Monday, June 17 6 p.m. All Attendee Reception Tuesday, June 18 7:30 a.m. Registration/Information Desk Opens 7:30 a.m. Breakfast 8 a.m. Welcome & Briefings on Subcommittee Topics 10 a.m. Subcommittee Breakouts Noon Keynote Speaker & Luncheon 1:30 p.m. Subcommittee Breakouts 5 p.m. Adjourn ***FREE NIGHT IN LEXINGTON - DINNER ON YOUR OWN *** Wednesday, June 19 7:30 a.m. Registration/Information Desk Opens 7:30 a.m. Breakfast 8 a.m. Subcommittee Breakouts 10:30 a.m. Subcommittee Briefings (all attendee general session) Noon Adjourn"
01877905b1d8410ad212674f39fb6b93b390398d22a2aba803390015445ba09d,"2017/Posada,_Elliot_3.17.17_-_7(b).pdf",2017,ELLIOT POSADA,,MASSACHUSETTS TRIAL COURT/SECURITY DEPARTMENT,"03/10/17 11:27PM EST '6177162120' 6177235851 Pg 1/4 DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING REENCYED ETHICS COMMISSION AS REQUIRED BY G. L. C. 268A, $ 7(b) STATE EMPLOYEE INFORMATION 2017 MAR 17 PM 4:24 Name of state employee: ELLIOT POSADA Title/ Position ASSISTANT CHIEF COURT OFFICER If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. If it applies to you. Agency/ Department MASSACHUSETTS TRIAL COURT/SECURITY DEPARTMENT Agency Address THREE PEMBERTON SQUARE, 15TH FLOOR BOSTON, MA 02108 Office phone: 617-788-8584 Office e-mail: jason.dickie@jud.state.ma.us Check one: Elected or Non-elected Starting date as a state employee. 6/29/1994 ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. Select either STATEMENT #1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I was elected to my compensated state employee position. I will continue to have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an X My financial Interest In a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. Select either STATEMENT # 1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to STATEMENT #2. have this financial interest in a state contract. MAR-10-2017 10:21 PM From:6177162120 IDETHICS-COMMISION Page:001 R=94% 03/10/17 11:27PM EST '6177162120' 6177235851 Pg 2/4 Write an X My financial interest in a state contract is: beside your financial interest. A state agency has a contract with me, but not an employment contract. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. - OR - STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest In a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address MASSACHUSETTS CONVENTION CENTER AUTHORITY of state agency that 415 SUMMER ST. made the contract BOSTON, MA 02210 ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an X My State Agency is not the contracting agency. to confirm these facts. My State Agency does not regulate the activities of the contracting agency. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. FILL IN - Please explain what the contract is for. THIS BOX OR THE BOX BELOW ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. FILL IN - Please identify the person or entity that has the contract with the state agency. - What is your relationship to the person or entity? THIS BOX - What is the contract for? OR THE BOX MSA SPEICALIZED SECURITY SOLUTIONS, LLC. ABOVE PRIVATE SECURITY GUARD EMPLOYEE ACCESS CONTROL/SECURITY SCREENING MAR-10-2017 10:22 PM From:6177162120 IDETHICS-COMMISION Page:002 R=94%"
018a953446efd2164e267f0ebb0c19877d57c130f5e6bccb79d051a6bdf56c7d,2023/Finegold_Barry_3.7.23_-_6A.pdf,2023,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. c. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public Barry Finegold official: Public official State Senator position: Public office Massachusetts State House address: 511-A 24 Beacon Street Boston, MA 02133 Office Phone: 617-722-1612 Office E-mail: Barry.Finegold@masenate.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action The Senate will take action on S.23, which will, in part, allow for certain legal documents to be to be taken: remotely notarized. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I have a financial interest in a law firm with a real estate practice that has an interest in the ability to remotely notarize documents to serve its clients. I also own and manage commercial real estate and residential rental housing property as a landlord. Public official's signature: Barry R. Inegold Date: 3/7/23 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
018da7f9431ef06350f2c0eb4bd7d7ab18c58da38edff24058128b676c8199ee,"2014/Benison,_Martin_section_6_disclosure_2014-10-16.pdf",2014,Martin J Benison,,Office of the Governor,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY ETHICS AS REQUIRED BY G. L. c. 268A, § 6 COMMISSION STATE EMPLOYEE INFORMATION 2014 OCT 16 An IU. 38 Name: Martin J Benison Title or Position: Comptroller of the Commonwealth State Agency: Office of the Comptroller Agency Address: Room 901 One Ashburton Place Boston Ma., 02108 Office Phone: 671 973 2315 Office E-mail: Martin.benison@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other As my term as Comptroller concludes January 8, 2015,I plan to discuss my future employment with proceeding, application, various individuals. Some ot these discussion will include conversations or meetings with people submission, request working for companies that are doing business with the Office of the Comptroller Where my for a ruling or other participation involves a particular matter, such as the review or approval of a contract, that may or determination, contract, will likely have an impact on that company's financial interest, I want to make required disclosures claim, controversy, under section 6 of Chapter 268A, charge, accusation, arrest, decision, determination, or finding. See attached memo. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: See attached memo. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. 1 am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter See attached memo. Employee signature: Date: Must I Been 10-14-14 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing The Honorable Deval Patrick Authority: Title or Position: Governor of the Commonwealth Agency/Department: Office of the Governor Agency Address: Room 360 State House Boston, MA. 02133 Office Phone: Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, 1 have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. 1 am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: 15 October 2014 Comment: I assign this particular matter to Deputy Comptroller and Chief Information Officer Chris Guido. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 The Commonwealth of Massachusetts Office of the Comptroller One Ashburton Place, Room 901 Boston, Massachusetts 02108 MARTIN J. BENISON PHONE (617) 727-5000 FAX (617) 727-2163 COMPTROLLER www.state.ma.us/osc/osc.htm To: The Honorable Deval Patrick, Governor CC: (Attn) Kate Cook, Governor)s Counsel From: Martin Benison, Comptrol Date: October 14, 2014 RE: G.L. c. 268A, s.6 Disclosure This memo provides a fuller discussion of my disclosure to you and request for a decision from you in accordance with section 6 of chapter 268A. My appointment as Comptroller expires with your term on January 8, 2015. It is an appropriate time for me to consider future job opportunities which will include seeking reappointment as Comptroller. There are conversations I may have with personnel from CGI that I believe require disclosure and your action under section 6 of chapter 268A CGI is the manufacturer of the Commonwealth's financial management system, we call MMARS. My office frequently has, and does currently have, contracts with CGI for modifications or enhancement to this system. Deputy Comptroller Chris Guido normally negotiates contracts and approves invoices with my oversight. I understand that these contracts are particular matters and any involvement that may be required of me in either such negotiations or oversight of Mr. Guida would constitute participation. It has come to my attention that CGI may have interest in adding a person to the team with skills similar to mine. I intend to reach out to them to discuss the possibility of future employment with CGI. I believe, therefore, that I will or may be negotiating for, or may have an arrangement concerning, future employment with, CGI. Consequentially, I will not participate in contract discussions or review of performance under the contract until I receive your decision. While I appreciate that you may make a determination pursuant to section 6 authorizing me to participate in such particular matters, I would recommend, and prefer, that you delegate this authority to Deputy Comptroller and Chief Information Officer Chris Guido. I have full confidence in Mr. Guido's ability to handles these matters in a professional, fair and impartial manner."
01911152a1d5c45b2dfad58633bc2c9371ad1e24eefd47202d79862bd81d54c9,"2019/Lesser,_Eric_Section_23_disclosure_3.1.19.pdf",2019,Eric P. Lesser 2019 MAR - I PM 3: 14,,Massachusetts Legislature,"DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. c. 268A, § 23(b)(3) RECEIVED PUBLIC EMPLOYEE INFORMATION TE THICS CUMMISSION Name of public Eric P. Lesser employee: 2019 MAR - I PM 3: 14 Title or Position: Senator, First Hampden & Hampshire District Agency/Department: Massachusetts Legislature Agency address: State House, Room 413C Boston, MA 02133 Office Phone: (617) 722-1291 Office E-mail: Eric.lesser@masenate.gov In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue The Massachusetts film tax credit incentive program may be the subject of an that is coming before amendment, or amendments, related to the General Appropriations Act, or other you for action or legislation. decision. What responsibility As member of the Massachusetts Senate, I may vote on an amendment, or amendments, do you have for to the General Appropriations Act, or other legislation regarding the Massachusetts film taking action or tax credit incentive program. making a decision? Explain your I serve as a consultant to Home Box Office Inc. in order to provide advice and review of relationship or ongoing scripts for the television show Veep. I do not believe that my work will result in affiliation to the any improper influence or undue enjoyment or influence, in the performance of my official person or duties. organization. How do your official I am submitting this disclosure in an abundance of caution, as no current conflicts exist. I actions or decision do not have decision-making nor management authority in my role with Veep. My matter to the person responsibility is to advise the creative team on the script and plot ideas. or organization? Optional: Additional facts - e.g., why there is a low risk of undue favoritism or improper influence. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, _X__ Taking into account the facts that I have disclosed above, I feel that I can perform you should my official duties objectively and fairly. recuse yourself. Employee signature: Eui P. Leve Date: February 27, 2019 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised July, 2012"
01a0dc6fb7016720213dfa65320c3a769f1f36488110df250f1c4cba993e6cbf,"2018/Van_Der_Linden,_Vincent_9.17.18_-_7(b).pdf",2018,Vincent Van Der Linden 2010 SEP 17 11 AM11:59,,Department of Mental Health,"DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING AGENCY AS REQUIRED BY G. L. C. 268A, § 7(b) RECEIVED TATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name of state Vincent Van Der Linden 2010 SEP 17 11 AM11:59 employee: Title/ Position Staff Investigator If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Agency/ Department Department of Mental Health Agency Address 25 Staniford Street Boston, MA 02114 Office phone: 617-626-8147 Office e-mail: Vincent.vanderlinden@massmail.state.ma.us. Check one: Elected or Non-elected Starting date as a state employee. May 22, 2016 ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. Select either STATEMENT #1: I had one of the following financial interests in a contract made by a state agency before I was elected to my compensated state employee position. I will continue to STATEMENT #1 or have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an X My financial interest in a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. Select either STATEMENT # 1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a state contract is: Write an X beside your financial interest. A state agency has a contract with me, but not an employment contract. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. -- OR -- STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest in a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address of state agency that Committee for Public Counsel Services (CPCS) made the contract Committee for Public Counsel Services Children and Family Law Division 44 Bromfield Street Boston, MA 02108 ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an X My State Agency is not the contracting agency. to confirm these facts. My State Agency does not regulate the activities of the contracting agency. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. - The contract is to provide services as an attorney to the Committee for Public Counsel Services FILL IN THIS BOX (CPCS) Children and Family Law (CAFL) Program. OR THE BOX BELOW ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. FILL IN - Please identify the person or entity that has the contract with the state agency. - What is your relationship to the person or entity? THIS BOX - What is the contract for? OR THE BOX ABOVE N/A"
01af939693e3c528883604efd21e00c62bafec35ea7063f2c6f5a1f39703fe90,2015/Donatopaul.pdf,2015,,,,"April 27, 2015 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Dear Commissioners: I write to disclose that I am an active state employee who receives or could receive health insurance through the Group Insurance Commission. Pending before the House of Representatives are two floor amendments relative to the FY'2016 budget: Amendment 403 has the effect of setting a 25% contribution rate for health insurance coverage for all active state employees. Amendment 903 has the effect of setting a 20% contribution rate for health insurance coverage for all active state employees. If adopted, changes to the contribution rates for state employees may have an effect on my personal financial interests which is different from the effect on the general public. I make this disclosure pursuant to G.L. c. 268A § 6A and consider it public in nature. Sincerely yours, Banl Hinats State Representative"
01c513249d4b3623f3f8fbf2571f9b8cf99d1812e7a6b3503b6b30372f04ca78,"2017/Brownsberger,_William_930_CMR_5.083b_5.16.17.pdf",2017,William Brownsberger,,,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF EXPENSES RELATED TO ATTENDANCE AT AN EVENT SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(3)(b) STATE RECEIVED COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected 2017 MAY 15 PH 4:55 public employee: William Brownsberger Title/ Position Massachusetts State Senator Office: Massachusetts State Senate Office address: Massachusetts State House, Room 504 24 Beacon Street Boston, MA 02133 Office phone: (617) 722-1280 Office E-mail: william.brownsberger@masenate.gov I am filing this disclosure because: Write an X My attendance at an event will serve a legitimate public purpose, i.e., it will promote the to confirm each interests of the Commonwealth, a county or a municipality; and statement. > A non-public entity (but not a lobbyist) has offered to pay or waive expenses worth more than $50 related to the event. EVENT ATTENDED Describe the event that you will attend. Massachusetts Bicycle Coalition 40th Anniversary Celebration Describe your participation in the Attending reception event. Date, time and location of event. Date: Tuesday, May 16, 2017 from 5:30 - 9:30 PM Location: John Hancock Financial, 601 Congress Street, Boston, MA 02210 EXPENSES RELATED TO INCIDENTAL HOSPITALITY Identify the person or organization that Massachusetts Bicycle Coalition offered to reimburse, pay or waive expenses. Address of person or organization. 50 Milk Street, 16th Floor Boston, MA 02109 Provide information Itemization and explanation of amounts offered: in as much detail as possible: Transportation: Air, train, bus, and taxi fare and rental car hire, etc. Meals: Breakfast, lunch, dinner, special events. Admission: Admission, tickets, etc. General Admission: $75 Other (please list): Refreshment, entertainment, etc. Total: $75 Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., will promote the interests of the Commonwealth, a county or check off a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Please explain how the activity will promote the Allows me to understand the concerns of bicycle safety advocates interests of the Commonwealth, a county or a municipality. Employee signature: 2022 stan. Pm Date: May 16, 2017 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Form revised February, 2012"
01c56b24a7186addefd8d2edd9892dd3b77dc8221b4f2c938abd28d73945ebee,2013/PatrickDeval10.22.13(2).pdf,2013,Deval L. Patrick,,,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF EXPENSES RELATED TO ATTENDANCE AT AN EVENT EIVED SERVING A LEGITIMATE PUBLIC PURPOSE TE ETHICS COMMISSION AS REQUIRED BY 930 CMR 5.08(3)(b) 2013 OCT 22 PM 2:20 ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Deval L. Patrick Title/ Position Governor Office: Office of the Governor Office address: State House Room 360 Boston, MA 02133 Office phone: (617) 725-4000 Office E-mail: I am filing this disclosure because: Write an X My attendance at an event will serve a legitimate public purpose, i.e., it will promote the to confirm each interests of the Commonwealth, a county or a municipality; and statement. A non-public entity (but not a lobbyist) has offered to pay or waive expenses worth more than $50 related to the event. EVENT ATTENDED Describe the event that you will attend. The Boston Philharmonic Orchestra is having a special performance of Beethoven's 9th Symphony to honor victims of the Boston Marathon bombing and first responders. Originally scheduled for April 19, the day of the lockdown following the bombings, this rescheduled performance is intended to celebrate the resilience of the community. Describe your participation in the I will be attending as a guest of Benjamin Zander and the Boston Philharmonic event. Orchestra. Date, time and location September 30, 2012 of event. 8PM Symphony Hall EXPENSES RELATED TO INCIDENTAL HOSPITALITY Identify the person or organization that Benjamin Zander offered to reimburse, Conductor pay or waive Boston Philharmonic Orchestra expenses. Address of person or 295 Huntington Ave., Suite 210 organization. Boston, MA 02115 Provide information Itemization and explanation of amounts offered: in as much detail as possible: Transportation: Air, train, bus, and taxi fare and rental car hire, etc. N/A Meals: Breakfast, lunch, dinner, special events. N/A Admission: Admission, tickets, etc. $100 Other (please list): Refreshment, entertainment, etc. N/A Total: $100 Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a legitimate public purpose i.e., will promote the interests of the Commonwealth, a county or to apply, a municipality; AND check off both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Please explain how the activity will promote the The Boston Philharmonic Orchestra features amateur, student and professional interests of the musicians. One of Boston's premier orchestras, the Boston Philharmonic follows a Commonwealth, a county vision of ""passionate music making without boundaries."" My attendance at the special or a municipality. presentation of Beethoven's 9th Symphony will promote the arts in in the Commonwealth and honor the victims and first responders of the Boston Marathon bombings. Employee signature: kate Cool by Kate Cook, Chief Legal Counsel to the Governor, designated to file on behalf of Governor Deval L. Patrick Date: 10/22/13 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Form revised February, 2012"
01cfe858bd8e94acb24ae5737e83be471906cd19bd280da634d2cb8769d3dbb7,2021/Ivas_Steve_11.8.2021_-_19.pdf,2021,Steve Ivas,,,"RECEIVED STATE ETHICS COMMISSION 2021 NOV -8 PM 12: 04 November 1, 2021 Massachusetts Ethics Commission One Ashburton Place Suite 619 Boston, MA 02108 Re: Steve Ivas/Cohasset Conservation Commission Dear Sir/Madam: With respect to the above referenced matter, enclosed herewith please find my report to the State Ethics Commission regarding a potential conflict. As is indicated in the Disclosure By Non-Elected Municipal Employee of Financial Interest, I am disclosing a potential conflict, which the Agent of the Conservation Commission brought to my attention by letter dated October 12, 2021. It set out below the salient facts to supplement the information in the Disclosure Form: 1. In March of 2020, I was retained by Marieke Berndsen, Daniel Rose III and Elizabeth Graham (hereinafter clients) to assist them in proposed work within the jurisdiction of the Cohasset Conservation Commission. 2. On March 18, 2021, I prepared and filed a Notice of Intent for my clients before the Cohasset Conservation Commission. Over the course of the new few months, I appeared at several public hearings for the clients. 3. After the last appearance before the Cohasset Conservation Commission for the clients, I was asked to serve as Interim Conservation Agent for the town of Cohasset. 4. Specifically, I was appointed Interim Conservation Agent for the Town of Cohasset from May 21, 2021 through August 17, 2021. 5. Before August 3, 2021, the Chair of the Conservation Commission requested that I write a final report on the clients' project certifying that the required work was done. 6. On September 13, 2021, I filed the requested report and made no charge to the clients for the same. In sum, I prepared the final report as an accommodation to the Commission and the clients. If such was a violation under MGL C. 268A, such was inadvertent. Should you require any additional information, please contact me. Very truly yours, Stem luat Steve Ivas WBS: jeg ENC. massachusetts ethics commission-ivas 102521 DISCLOSURE BY NON-ELECTED MUNICIPAL EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 19 MUNICIPAL EMPLOYEE INFORMATION Name: Steve Ivas Title or Position: Interim Conservation Agent Municipal Agency: Cohasset Conservation Commission Agency Address: 41 Highland Ave ZOZI NOV -8 PHII: 05 STATE ETHICS COMMISSION RECEIVED Cohasset, MA 02025 Office Phone: (781) 383-4100 ext. 5104 Office E-mail: cpechtl@cohassetma.org My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other Interim Conservation Agent in Cohasset from May 6, 2021 through August 17, 2021. proceeding, application, submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: Previously, I was retained by private homeowners in March of 2020 to change a coastal E.g., approval, bank to eliminate an invasive species. The Commission required filing of an NOI and I disapproval, decision, recommendation, prepared for and attended public hearings. Before August 3, 2021, the Conservation rendering advice, investigation, other. Commission Chair requested that I file a status report regarding the project. I did so and made no charge to the clients for the same. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter I was paid for work by Cohasset for May and June, but am owed wages for July and August, $6,975 and $3,105, respectively, for a total of $10,080.00. Employee signature: Date: 02 NOV 21 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Title or Position: Agency/Department: Agency Address: Office Phone: Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 19, I have reviewed the particular matter and appointing authority: the financial interest identified above by a municipal employee. I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the municipality may expect from the employee. Appointing Authority signature: Date: Comment: Attach additional pages if necessary. The appointing authority shall keep this Disclosure and Determination as a public record. Form revised February, 2012"
01d521fc511cd01d40b3f16fafc986a6c39a272885161cc40afbe98d9ee1140d,2015/BraunEdward_(2).pdf,2015,,,,"Bridgewater State University STATE ETHICS COMMISSION DISCLOSURE FORM RECEIVEDMISSION STATE TO: Dana Mohler-Faria, President, Bridgewater State University 2015 JAN 14 AM 9:45 FROM: Professor BRAUN MAHPLS Department RE: Disclosure of Decision to Adopt Instructional Materials That I Have Authored/Published In compliance with the Massachusetts G.L.c.268A, §6, I disclose my intent to adopt the following: Semester: Fall Year: 2014 Day ( ) DGCE ( ) Non-credit check all that apply Course Number and Title: Course enrollment: 60 students in Z sections. Full description of materials (e.g. bibliographic entry for text, workbook, course-pack, CD, etc.): TEXTBOOK: Fundamentals of EASRECISE Physiology 5th Edition If this is a published work sold to students through a 3rd party such as the bookstore: Check all that apply I am the author ( ) I am the editor ( ) Other ( ) I am the co-author ( ) I am the co-editor From the sale of this material to my Bridgewater State University students, I anticipate that I will receive royalties in the amount of $ 500.- See Attached If you are the publisher of this work and are selling it directly to students: From the direct sale of this material to my Bridgewater State University students, I anticipate that I will receive income of $ of which $ is profit. In the event that you determine that this financial interest is sufficiently substantial to warrant assigning to someone else the decision about what course materials should be adopted for use in the course identified above, I agree to allow the Department Chair/Graduate Program Coordinator/Dean to make that decision in my stead. Road Been Signature of Faculty Member August Date 5, 2014 Determination of Bridgewater State University Appointing Authority ( ) I have reviewed this matter and determine that the faculty member's financial interest as disclosed above is not sufficiently substantial to warrant my assigning to someone else the decision about what course materials should be adopted for use in the course identified above. ( ) I have reviewed this matter and determine that the faculty member's financial interest is sufficiently substantial to warrant my assigning the decision in question to someone else. Therefore, in accordance with M.G.L.c.268A, §6, I assign that decision to the Department Chair/Graduate Program Coordinator/Dean (in the case of a department chair). 12/23/14 Dana Mohler-Faria, President Date August 5, 2014 The Text is designed specifically for this course. It combines both lecture and lab material. It is estimated that ""about"" 50 students will purchase the book. The Wholesale charge to the bookstore is $50 per book ($10 of which is profit). Total Profit: $ 500. @ 50 students X $ 10 $ 500"
01d8995ad8bdfffee7bb70c6fd5ff002c874cccfc80c1e21c284b48c51008b66,"2019/Rausch,_Rebecca_930CMR5.082d2_disclosure_9.17.19.pdf",2019,Rebecca L. Rausch,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. STATE NECEIVED ETHICS COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION 2019 SEP 17 PM 3:30 Name of elected Rebecca L. Rausch public employee: Title/ Position Senator Agency/ Department Massachusetts Senate Agency address: State House Boston, MA 02133 Office phone: 617 722 1555 Office e-mail: Becca.rausch@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I am traveling to attend the Center for Reproductive Rights' 2019 State Summit. traveling. Describe your participation in the I will be attending panels and meeting with advocates and other policymakers to activity. discuss issues relative to reproductive rights and to learn about law and policy in other states and at the national level. Date, time and location 9/25/2019 from 8:30 AM - - 5 PM of activity. Ronald Reagan Building and International Trade Center 1300 Pennsylvania Avenue Northwest Washington, DC 20004 Please explain how the activity will promote the Attending this event will improve my knowledge of issues relative to reproductive rights interests of the and help me improve my ability to implement and advocate for policies relative to Commonwealth, a county or a municipality. reproductive rights. TRAVEL EXPENSES Identify the person or organization that The Center for Reproductive Rights offered to reimburse, Point of contact: Ashley Gray waive or pay your Tel 917 637 3625 Fax 917 637 3666 Mobile 615 934 2782 travel expenses. Address of person or 199 Water Street, 22nd Floor organization. New York NY 10038 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Flight from BOS to DC: $ 304.60 Transportation: Room rate: $350.00, only for the night of the 24th. Lodging: The cost of a second night will be covered by CRR if a 2nd night is needed due to flight limitations. In the event of this occurring, I will submit any additional disclosure as required by law. Breakfast, Lunch, and snacks throughout the day on Sept. 25 at the Meals: Summit (approx. $100 per person) Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): N/A Total: $754.60 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person Employee signature: providing notes the reimbursement. waiver or payment. Date: 9/17/19 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court- file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. 2019 State Summit Agenda (DRAFT) 8:30-9:00 AM: Breakfast & Check-In 9:00-9:15 AM: Welcome Remarks (Pavilion) 9:15-10:30 AM: Lessons Learned from Ireland & Argentina (Pavilion) Moderator: (CRR TBD) Grainne Griffin Title, Abortion Rights Campaign (confirmed & registered) Adam May Title, Coalition to Repeal the 8th (confirmed & registered) Mariela Belski Executive Director, Amnesty International Argentina (confirmed & registered) Lola Guerra Regional Coordinator (Latin America & Caribbean), Católicas por el derecho a decider (confirmed & registered) Giselle Carino CEO & Regional Director, International Planned Parenthood Federation/Western Hemisphere Region (tentative) Next steps: Schedule call (doodle sent), draft questions/bios, confirm with Giselle 10:30-10:45 AM: Break 10:45-12:15 PM: Lessons Learned from New York & Illinois (Pavilion) Moderator: (CRR TBD) Katharine Bodde Senior Policy Counsel, NYCLU (confirmed & registered) Emily Kadar Senior Manager of Political & Government Affairs, National Institute for Reproductive Health (confirmed & registered) Michaelle Solages Assemblymember, New York Khadine Bennett Director of Advocacy and Intergovernmental Affairs, ACLU of Illinois (confirmed & registered) Kelly Cassidy Representative for 14th District, Illinois (confirmed & registered) Next steps: Confirm legislator speakers, Schedule call, draft questions/bios, include shutout for other legislators who worked on bills this session in intro 12:15-1:30 PM: Seated Lunch (Pavilion) Advocate Track 1:30-3:00 PM: Medicaid & Maternal Health (Pavilion) (Breana will coordinate a planning call with the panelists) Moderator: Breana Lipscomb Manager, U.S. Maternal Health & Rights Campaigns, Center for Reproductive Rights (confirmed) Fabiola Carrión Senior Attorney, National Health Law Program (confirmed & registered) Chanel Porchia-Albert Executive Director, Ancient Song Doula Services-NY (confirmed & sent link) Helen Arega Program Director, Abortion Care Training Incubator for Outstanding Nurse Scholars (ACTIONS) - CA (confirmed & registered) Nadia Hussain Maternal Justice Campaign Director, MomsRising (confirmed & registered) - NJ"
01d9d4dd607a310f029e6f198be58bcf8cfa9121aab95dfc43809dad24cc0fc8,2015/GreerJames.pdf,2015,James Greer,,DYS,"] RECEIVED STATE ETHICS COMMISSION DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A CONTRACT TO PROVIDE SOCIAL SERVICES 3 AM 10: 09 PURSUANT TO 930 CMR 6.07 STATE EMPLOYEE INFORMATION Name of state employee: James Greer Title/ Position: Groupworker III Agency/Department: DYS Agency Address: 425 Harvard St. Dorchester, MA 02124 Office phone: (617)740-0285 Office e-mail James: e. green state maius I am a state employee, and I seek to have a financial interest in a contract or agreement made by a state agency listed below, or by a provider or organization funded by a state agency listed below: A state agency within the following Executive Offices: Executive Office of Health and Human Services, Including the Human Service Transportation Office; Executive Office of Public Safety and Security, Executive Office of Elder Affairs, Executive Office of Veteran's Services, or A sheriff's office. The purpose of the contract is: - To provide personal services to a person or persons who receive services from, or have services paid for by, these state agencles; or - To provide educational services to people who work for these state agencies or for providers or organizations funded by these state agencies. I seek- approval of the arrangement from the agency for which I serve as a state employee and from the state agency above that made the contract. FINANCIAL INTEREST IN A CONTRACT WITH A STATE AGENCY PLEASE CHECK OFF ONE OF THE THREE STATEMENTS BELOW AND PROVIDE THE REQUESTED INFORMATION. 1). Service to a state agency I will provide personal or educational services to a state agency listed above, Please identify the state agency and also the Executive Office it is in, if applicable. 2) Service to a provider or - will provide personal or educational services to a provider or organization funded by a state organization agency listed above. Please provide the name and address of the provider or organization. Eliot Community Human Services Please Identify the state agency that funds the provider or organization, and also the Executive Office it is in, If applicable. 3) Service to a person or persons I will provide personal services directly to a person or persons who receive services from, or have services paid for by, a state agency listed above. Please identify the state agency that provides services to, or pays for services for, the person or persons, and also the Executive Office it is In, if applicable. Please describe the Please provide information about the type of personal or educational services you will provide. services you will Please do not Include the name of any Individual who receives services. provide. Relief Staff What will you be Please include a dollar amount, if possible. paid, or what other financial interest will you have? Employee signature Date: J APPROVAL BY AGENCY YOU SERVE AS A STATE EMPLOYEE Name and title of appointing authority Cata Fabes Office phone Office e-mail Signature by By signing here, l'indicate that I have reviewed the facts that the state employee has appointing authority disclosed above and approve the arrangement proposed by the state employee. Date: Ba 4.3.15 APPROVAL BY AGENCY THAT MADE THE CONTRACT (IF DIFFERENT) Name and title of person giving approval at the state agency that made the contract Office phone Office e-mail Signature by person By signing here, I indicate that I have reviewed the facts that the state employee has giving approval disclosed above and approve the arrangement proposed by the state employee. Chin J. For Date: 4.3.15 Attach additional pages if necessary. File with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012"
01de30605ddd0039913ef2a85370a248b6c12d40ddbbecf48bb710e0df13609e,2014/wolfDaniel6.26(3).pdf,2014,Daniel A. Wolf,,,"The Commonwealth of Massachusetts ENSE PETIT OVIETEM MASSACHUSETTS SENATE STATE ETHICS RECEIVED COMMISSION Chairman Vice Chairman STATE ADMINISTRATION AND REGULATORY OVERSIGHT SENATOR DANIEL A. WOLF Cape and Islands District ENVIRONMENT, NATURAL RESOURCES AND AGRICULTURE STATE HOUSE, ROOM 511C BOSTON, MA 02133-1053 COMMUNITY DEVELOPMENT AND SMALL BUSINESS TEL. (617) 722-1570 FAX (617) 722-1271 PUBLIC SERVICE DANIEL.WOLF@MASENATE.GOV TOURISM, ARTS AND www.MASENATE.GOV CULTURAL DEVELOPMENT VETERANS AND FEDERAL AFFAIRS March 4, 2014 Karen Nober Commonwealth of Massachusetts, State Ethics Commission John W. McCormack Office Building 1 Ashburton Place, Room 619 Boston, MA 02108-1501 Dear Ms. Nober, Enclosed please find my completed disclosure form, pursuant to 930 CMR 6.26(3), disclosing my financial interest in two contracts between Cape Air and Massport, an Operating Agreement and a Terminal Lease Agreement, that pre-dated my election. I am also enclosing copies of the contracts for your review. If you have any additional questions about my disclosure or the contracts, please do not hesitate to contact me. Sincerely, Deacy Daniel A. Wolf DISCLOSURE BY PUBLIC EMPLOYEE OF FINANCIAL INTERECEIVED COMMISSION IN A PUBLIC CONTRACT PRE-DATING ELECTION OR APPOINTMENT AS REQUIRED BY 930 CMR 6.26(3) 2014 MAR -4 PM :59 PUBLIC EMPLOYEE INFORMATION Name of public Daniel A. Wolf employee: PLEASE WRITE AN X NEXT TO THE STATEMENT THAT APPLIES TO YOU: I am an elected or appointed state, county or municipal employee. Date of election or appointment: November 2, 2010 . A public agency has a contract with my company or organization, and I am a ""key employee"" under the contract. Date of contract: _April 11, 2002 (Operating Agreement), May 1, 2002 (Lease Agreement). Name and address of your company or organization: Hyannis Air Service, Inc., d/b/a Cape Air, 660 Barnstable Road, Hyannis, MA 02601 Title/ Position State Senator, Cape & Islands State, County or I serve the public agency below: Municipal Agency/ Department Massachusetts State Senate Public Agency Address Room 511c, Statehouse Boston, MA 02133 Office phone: (617) 722-1570 Office e-mail: daniel.wolf@masenate.gov I am disclosing that I will retain a direct or indirect financial interest in a public contract that pre-dated my election or appointment as a public employee. PUBLIC CONTRACT INFORMATION PLEASE WRITE AN X BESIDE THE STATEMENT THAT DESCRIBES THE PUBLIC CONTRACT. I have a contract with a public agency. A public agency has a contract with another person or an entity, such as a corporation, company or organization, and I have a financial interest in the contract. Please provide the name and address of the person or entity that has the contract with the public agency: Hyannis Air Service, Inc. d/b/a Cape Air 660 Bamstable Road Hyannis, MA 02601 . If the public contract involves your being employed by a public agency, having employment that is funded by a public agency, or providing legal or other professional services to a public agency, then you may not use the exemption under 930 CMR 6.26(3). PLEASE CONFIRM THAT YOU ARE ELIGIBLE TO USE THE EXEMPTION BY WRITING AN X NEXT TO THE FOLLOWING STATEMENT: I confirm that the public contract is not for the purposes listed above. Name and address of public agency that Massachusetts Port Authority is a party to the 1 Harborside Drive, #200F public contract Boston, MA 02128 Please explain what the public contract is 1) Operating Agreement to provide air service at Logan Airport; and for. 2) Boston-Logan International Airport Terminal Lease YOUR FINANCIAL INTEREST IN THE PUBLIC CONTRACT Please explain your For example: financial interest What is your percentage interest in the contract amount? in the public What interest do you have in the contract as a result of your ownership interest in an entity that has the contract with the public agency? contract. What are the financial benefits or obligations that you have as a result of the contract? I have an ownership interest of approximately 20% in Hyannis Air Service, Inc. d/b/a Cape Air. Date when you acquired a financial Same as commencement date of the public contract interest in the public contract Other (specify date) DURATION OF THE PUBLIC CONTRACT Commencement date of the public March 1, 2002 (Operating Agreement), on or about May 1, 2002 (Lease Agreement) contract Original termination PLEASE NOTE: Your exemption under 930 CMR 6.26 ends on the original termination date date of the public unless the public contract can be automatically extended or renewed as specified in 930 contract CMR 6.26. February 28, 2003 (Operating Agreement); Lease Agreement continues from calendar month to calendar month until terminated by either party Please complete these AUTOMATIC EXTENSION questions if the public contract provides that it PLEASE CONFIRM THE STATEMENT BELOW BY WRITING AN X NEXT TO IT: can be extended. I understand that I can use the exemption under 930 CMR 6.26(3) to retain my interest in an extension of the contract only if: - The extension is automatic without any action taken by either party; and - The same terms and conditions that applied in the original contract term will apply during the additional term. NOTE: Changes in contract payments will not be considered a change in the terms and conditions as long as the methodology for computing such changes is specified in the original contract, such that no negotiations are needed or required. Please answer these RENEWAL OF CONTRACT questions only if the public contract can be PLEASE CONFIRM THE STATEMENT BELOW BY WRITING AN X NEXT TO IT:"
01e151dac9e90a2fa23fef6d69eabf2499544a1c9018d845bd45a56dd434b906,2014/OkemanGail2.pdf,2014,,,,"0001/0001 -0/08/2014 12: 42PM FAX RECEIVED STATE ETHICS COMMISSION FITCHBURG STATE UNIVERSITY 2014 OCT 23 AM 10: 29 MEMORANDUM Date: 10/9/14 To: Robert V. Antonucci, President From: GuilDienman Department: Center Jor Proj Stadies Re: Disclosure of Decision to Adopt Instructional Materials in Whose Sale I Have a Financial Interest In compliance with the Massachusetts G.L.c.268A. $6, Ldisclose my intent to adopt the following: Semester: Fall Year: 2014 Day LOCGE X ) Non-Credit check all that apply Title: Course Meeting Number/Name The Diverse Students Full Description of materials (c.g., published text, course-pack, CD, etc.) (use reverse side of form if necessary) Publisleskyt: Developing Minds- If this is a published work sold to students through a 3rd party such as и bookstore: Check all that apply ( I am the author () I am the editor ) Other (indicate) I'am the co-author () I am the co-editor From sales of this title to Fitchburg State University students I anticipate that I will receive royalties in the amount of $ r 5% NOTE: Please be aware that faculty are prohibited from selling materials directly to students. In the event you determine that my financial interest is sufficiently substantial to warrant assigning to someone elsc the decision whether the instructional materials described above should be adopted for use in the course identified above, I agree to the Department Chair/Graduate Program Coordinator or designee to make that decision in Sior Signature of Faculty Member 10/9/14 Date Determination of Fitchburg State University Appointing Authority ( I have reviewed this matter and determine that the faculty member's financial interest as disclosed above is not sufficiently substantial to warrant my assigning to someone clse the decision whether the instructional materials described above should be adopted for use in the course identified above. ( ) I have reviewed this matter and determine that the faculty member's financial interest is sufficiently substantial to warrant my assigning the decision in question to someone clse. Therefore, in accordance with M.G.L.c.268A, §6. 1 assign that decision to the appropriate administrative office. 10/16/2014 Robert V. Antonucci, President Date"
01e65afa2009c047e6f6a4b7739b2df102ea4f6fa15ed15f7e2eb116cab5d940,"2025/Oliveira,_Jacob_930CMR5.082d2_disclosure_6.27.25.pdf",2025,Jacob R. Oliveira,,Massachusetts State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Jacob R. Oliveira Title/ Position State Senator Agency/ Department Massachusetts State Senate Agency address: 24 Beacon St. Room 416-B Boston, MA, 02133 Office phone: (617) 722-1291 Office e-mail: Jacob.Oliveira@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity I will be joining other elected political leaders in Lisbon, Portugal, to participate in which is the reason for meetings bringing together Portuguese and Portuguese American elected officials at traveling. the Luso-American Legislators' Dialogue. Describe your participation in the During this event, I will meet with Portuguese and United States officials and attend activity. panels on Portuguese American issues and relations. Date, time and location June 30 - July 1, 2025 of activity. Lisbon, Portugal Please explain how the Massachusetts is home to a large Portuguese American community, and there are activity will promote the significant economic, cultural, environmental, and other issues of mutual interest to interests of the Portugal and Massachusetts. My participation in this event will inform my work as a Commonwealth, a county policymaker in addressing the issues experienced by the Portuguese American or a municipality. community in Massachusetts and my district and promote the bilateral relationship between the United States and Portugal. TRAVEL EXPENSES Identify the person or organization that The Luso-American Development Foundation (FLAD) offered to reimburse, waive or pay your travel expenses. Address of person or Rua Sacramento à Lapa, 21 organization. 1249-090 Lisbon, Portugal Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc Transportation: Airfare: $1,663.98 Ground Transportation: $80 Overnight accommodations. Lodging: $900.00 Breakfast, lunch, dinner, special events. Meals: $280.00 Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: $2,923.98 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Date: 6/27/2025 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
01ec0330d101944e11e00a7c55dd24de47d09c10dc3def879507d557cfa948b2,"2013/Joyce,_Brian_section_23_disclosure_2013-02-05_(2).pdf",2013,Brian A. Joyce,,Senate,"DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. C. 268A, § 23(b)(3) PUBLIC EMPLOYEE INFORMATION RECEIVED OMMISSION Name of public employee: Brian A. Joyce 2013 FEB -5 PH 2: 51 Title or Position: State Senator Agency/Department: Senate Agency address: State House Room 109D, Boston, MA 02133 Office Phone: (617) 722-1643 Office E-mail: Brian.A.Joyce@masenate.gov In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue I intend to file legislation that will require public utilities to exercise their franchise rights in that is coming before a manner consistent with the best interests of consumers. you for action or decision. What responsibility do you have for taking action or As a Senator, I will propose the legislation, discuss it with my colleagues, and vote on it. making a decision? Explain your relationship or In my private capacity as an attorney, I do or expect to represent Stonehill College and/or affiliation to the its energy broker or supplier in connection with the College's effort to establish a solar person or array and reduce its utility bills. Part of my representation includes negotiating on the organization. College's behalf with National Grid with respect to the utility's franchise right in Route 138. How do your official actions or decision matter to the person If the legislation I intend to propose is enacted, it may make it easier for energy or organization? consumers wishing to adopt alternative energy source, as Stonehill College does, to proceed with such plans, without the obstacle of a public utility vetoing the idea by exercise of its franchise rights. Optional: Additional facts - e.g., why there is a low risk of I believe it is in the best inerests of the Commonwealth to encourage energy consumers to undue favoritism or adopt alternative energy sources such as solar. I would be in favor of the legislation I improper influence. intend to propose whether or not I represented any client with respect to creation of solar array. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, Taking into account the facts that I have disclosed above, I feel that I can perform you should recuse yourself. Employee signature: Date: my official Bafer duties objectively and fairly. 1/29/13 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee."
01f0b0065f158303a38257b1c73ae84fac231fbcb6ccdb7d39ce4d75464fee26,2015/CreemCynthiaStone.pdf,2015,Cynthia Stone Creem 2015 APR,,Massachusetts Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMRSTEETHICS: COMMISSION Name of elected Cynthia Stone Creem ELECTED PUBLIC EMPLOYEE INFORMATION 2015 APR 15 PM 2:09 public employee: Title/ Position State Senator Agency/ Department Massachusetts Senate Agency address: 24 Beacon Street, Boston, MA 02133 Office phone: 617 722-1639 Office e-mail: Cynthia.creem@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for Traveling to Ponta Delgada to join elected political leaders in participating in the traveling. inauguration of the Sahar Hassamain Synagogue Describe your participation in the I have been actively involved in the restoration of the synagogue with the Azorean activity. Jewish Heritage Foundation to raise funds to help with the restoration. Date, time and location April 22 - 26, 2015 Ponta Delgada, Azores of activity. Please explain how the This activity will promote the bilateral relationship between the United States and activity will promote the Portugal interests of the Commonwealth, a county or a municipality. TRAVEL EXPENSES Identify the person or organization that Municipality of Ponta Delgada, Azores offered to reimburse, Autonomous Regional Government of Ponta Delgada, Azores waive or pay your Dr. Augusto de Athayde travel expenses. Azorean Jewish Heritage Foundation (AJHF) Columbia Travel, Fall River, MA Address of person or organization. Various organizations donating through the AJHF AJHF P.O. Box 1243 Somerset, MA 02726 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Bus transportation, Transfers from airport, and sightseeing tours Ground approx. $100.00 per person Overnight accommodations. Lodging: Breakfast, lunch, dinner, special events. Meals: 1 Lunch, 3 Dinners, and 2 Receptions Meals, approx. $150.00 per person Registration, admission, tickets, etc. Admission: Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: Approx. $ 250.00 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: CyAnce Stre Crum Date: Claril 9,2015 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission."
01fbd4409493578360306b896eeef641eb47e4a8c738e8e4108b26f5b0cdcdb5,"2016/Summergrad,_Paul_section_6_disclosure_1.11.16.pdf",2016,STATE EMPLOYEE'S INFORMATION Dr. Paul Summergrad,,Office of the Attorney General,"THE COMMONWEALTH OF MASSACHUSETESIVED ENSE PETIT OVIETEM OFFICE OF THE ATTORNEY GENERAL COMMISSION ONE ASHBURTON PLACE 2016 JAN 11 AM IO: 30 BOSTON, MASSACHUSETTS 02108 MAURA HEALEY TEL: (617) 727-2200 ATTORNEY GENERAL www.mass.gov/ago January 8, 2016 State Ethics Commission One Ashburton Place Boston, MA 02108 Re: Disclosure of Possible Financial Interest under G.L. 268A, § 6 To Whom It May Concern: Enclosed is a disclosure under G.L. 268A, § 6 that the Office of the Attorney General is submitting on behalf of a special state employee (expert), the Office has reviewed the matter and the financial interest identified, and has made a determination. If you have any questions concerning this letter, please contact me at 617.963.2018. Thank you. Juzz Very truly yours, Judy Zeprun Kalman General Counsel SEIU THE ORNET CENTRAL RECEIVED STATE ETHICS COMMISSION DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL THESTAN 1 AM IO: 30 AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 01 Name: STATE EMPLOYEE'S INFORMATION Dr. Paul Summergrad Title or Position: Consulting expert State Agency: Office of the Attorney General (AGO) Agency Address: One Ashburton Place, 18th Floor Boston, MA 02108 Office Phone: c/o General Counsel's Office 617.963.2018 Office E-mail: c/o Judy.Zeprun@state.ma.us PARTICULAR MATTER Particular matter Please describe the particular matter: The Health Care Division (HCD) of the AGO is investigating health E.g., a judicial or other insurers' compliance with state and federal behavioral health parity laws, including, among other issues, proceeding, application, unequal or low reimbursement rates for behavioral health providers. submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter: I will be participation in the retained by the AGO to provide analysis and advice in connection with the AGO's investigation of particular matter: compliance with behavioral health parity laws. E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that O I have a financial interest in the matter. apply. X My immediate family member has a financial interest in the matter. O My business partner has a financial interest in the matter. X I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. O I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest If the investigation results in an increase in reimbursement rates by insurers for the provision of behavioral in the matter health services, my employer, Tufts Medical Center Physicians Organization, will, as a result, receive increased compensation. My financial interest in this matter is the same as the interests of all other behavioral health professionals who work for entities that receive fees from insurers for the provision of covered services. My wife Randy Glassman, MD has a small part time private practice as a psychiatrist under which she receives insurance payments. Her financial interest in this matter is the same as the interests of all other behavioral health professionals that receive fees from insurers for the provision of covered services. Employee signature: Date: 1.5.16 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Maura Healey, Attorney General Authority: By: Judy Zeprun Kalman Title or Position: General Counsel Agency/Department: Office of the Attorney General Agency Address: One Ashburton Place, 18th Floor Boston, MA 02108 Office Phone: 617.963.2018 Office E-mail: Judy.zeprun@state.ma.us DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or X I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: on Date: 1/7/16 Comment: Attach additional pages if necessary. Send to General Counsel's Office for Determination. GCO will send a copy of this disclosure to: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108"
01febef72af05c0fe17798e13dbbdaecd03ecc7a302e8cb8d179a4bf9abaf5e5,"2018/Jehlen,_Patricia_6.14.18_-_CMR_5.08(3)(b).pdf",2018,Patricia Jehlen,,,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF EXPENSES RELATED TO ATTENDANCE AT AN EVENT SERVING A LEGITIMATE PUBLIC PURPOSE RECEIVED STATE BILLOS COMMISSION AS REQUIRED BY 930 CMR 5.08(3)(b) 2018 JUN 14 PM 2:19 ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Patricia Jehlen Title/ Position Senator Office: Middlesex Second Senate Office address: Massachusetts State House 24 Beacon St Boston, MA 02133 Office phone: 617 722 1578 Office E-mail: Patricia.jehlen@masenate.gov I am filing this disclosure because: Write an X My attendance at an event will serve a legitimate public purpose, i.e., it will promote the to confirm each interests of the Commonwealth, a county or a municipality; and statement. A non-public entity (but not a lobbyist) has offered to pay or waive expenses worth more than $50 related to the event. EVENT ATTENDED Describe the event that you will attend. The annual British American Business Council of New England Award Luncheon honoring local businessman Arthur Mabbett for contributing to business partnerships between the US and UK. Describe your participation in the event. Presentation of a citation congratulating Mr. Mabbett and his company on the award. Date, time and location of event. June 26th 2018, UMASS Boston EXPENSES RELATED TO INCIDENTAL HOSPITALITY Identify the person or organization that British American Business Council of New England offered to reimburse, pay or waive expenses. Address of person or organization. 523 Lewis Wharf, Boston, MA 02110 Provide information Itemization and explanation of amounts offered: in as much detail as possible: Transportation: Air, train, bus, and taxi fare and rental car hire, etc. n/a Meals: Breakfast, lunch, dinner, special events. Lunch, included in admission Admission: Admission, tickets, etc. Admission, $150, includes Lunch Other (please list): Refreshment, entertainment, etc. n/a Total: $150 Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., will promote the interests of the Commonwealth, a county or check off a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Please explain how the activity will promote the Recognizing and supporting the accomplishments of the constituents of the 2nd interests of the Middlesex and their importance to the community and the commonwealth. Commonwealth, a county or a municipality. Employee signature: Date: June 14,11018 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Form revised February, 2012"
021420f218197be64a8b18856b16559d980c415b4f33c890dff90b312c2bbdf4,"2019/Ferrari,_Courtney_section_6_disclosure_9.18.19.pdf",2019,Courtney Ferrari,,Board of Bar Overseers of the Supreme Judicial Court,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 2019 SEP AM10:45 STATE EMPLOYEE INFORMATION Name: Courtney Ferrari Title or Position: Investigator State Agency: Board of Bar Overseers of the Supreme Judicial Court, Office of Bar Counsel Agency Address: 99 High Street Second Floor Boston, MA 02110-2320 Office Phone: 617-728-8750 Office E-mail: C.Ferrari@massbbo.org My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other Participation on an Office of Bar Counsel employee group that will meet with potential proceeding, application, candidates for the chief Bar Counsel position. Pursuant to court rule, the chief Bar submission, request for a ruling or other Counsel is appointed by the Board of Bar Overseers of the Supreme Judicial Court with determination, contract, the approval of the court. claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: A search committee has been appointed to assist the board in conducting a search for the new Chief Bar Counsel. The committee has overseen the search and is prepared to refer E.g., approval, candidates to the board. I have been invited to participate on a panel of Bar Counsel disapproval, decision, recommendation, Office staff who, prior to an appointment, will meet with individuals referred to the board by the search committee. rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter The individual appointed as chief Bar Counsel will be my supervisor, responsible for my work assignment, approving my annual evaluations, and compensation adjustments consistent with a collective bargaining agreement. The dollar amount is unknown. Employee signature: Contrey Few Date: 5/8/19 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Gregory J. Wenger Authority: Title or Position: Executive Director Agency/Department: Board of Bar Overseers of the Supreme Judicial Court Agency Address: 99 High Street Second Floor Boston, MA 02110-2320 Office Phone: (617) 728-8739 Office E-mail g.wenger@massbbo.org DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
021ad0a502579cd7754a6fbe5c7a515ae07bd8bc05adbd92605a27632c631ebf,"2016/Rosenberg,_Stanley_section_6A_disclosure_2016-07-21.pdf",2016,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6A RECEIVED STATE ETHICS COMMISSION PUBLIC OFFICIAL INFORMATION Name of public 2016 JUL 21 PM 3: 43 official: Stan Rosenberg Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1500 Office E-mail: Stan, Rosenberg 00 masenate you I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the Governor's to be taken: actions with respect to the fiscal year 2017 budget. One issue to be considered is whether the budget should include language that would change the Commonwealth's health insurance contribution for active state employees who were hired before July 1, 2003 and who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I have been a state employee since before July 1, 2003 and I receive health insurance though the Group Insurance Commission. Action on the Governor's proposed change would affect the amount of my annual contribution for health insurance. Public official's signature: Stan Ronay Date: July 20, 2016 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
021c3a007d7df5cd992bc5de1b39befa9c8a9f492479198dc1def499605eab15,"2018/Tarr,_Bruce_section_23_disclosure_2.9.18.pdf",2018,2018 FEB -9 PM 1:47 Bruce Tarr,,Massachusetts Senate,"20-18-1090 DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. C. 268A, § 23(b)(3) RECEIVED STATE ETHICS COMMISSION PUBLIC EMPLOYEE INFORMATION Name of public 2018 FEB -9 PM 1:47 employee: Bruce Tarr Title or Position: Senator Agency/Department: Massachusetts Senate Agency address: State House Boston, MA 02133 Office Phone: 617-722-1600 Office E-mail: Bruce.Tarr@masenate.gov In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when 1 perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue S2269 - relative to the used vehicle record book: This legislation would allow Class 1, that is coming before Class 2, and Class 3 motor vehicle dealers to record and maintain their Used Vehicle you for action or Record Book in electronic format as part of their electronic data management system. decision. It would also allow the Registry of Motor Vehicles to require Class 1, Class 2, and Class 3 motor vehicle dealers to maintain or make readily available a printout of the used vehicle record of a specific vehicle, or each vehicle on the dealer's premises on the date of inspection and of each vehicle acquired, sold or traded during the previous 7 days. The summary of the legislation was prepared by the Senate Committee on Ways and Means. What responsibility do you have for S.2269-relative to the used vehicle record book, will likely come before the senate for a taking action or vote in the current legislative session making a decision? Explain your relationship or My uncle and cousin operate used car dealerships licensed by the Commonwealth. I do affiliation to the not have any financial stake. person or organization. How do your official In theory allowing for recording in electronic format could save the dealership operating actions or decision expenses. matter to the person or organization? Optional: Additional facts - e.g., why there is a low risk of undue favoritism or improper influence. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, _X_ Taking into account the facts that I have disclosed above, I feel that I can perform my you should official duties objectively and fairly. recuse yourself. Employee signature: Date: 1/30/18 Attach additional pages if necessary. Not elected to your public position - file with your appointing authority. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised July, 2012"
0221fd8ab189ddb162c81a5a6929d8841269f1a62a4ca53bcca209ee6f7697a9,"2018/Moore,_Michael_Amended_930CMR5.082d2_disclosure_8.10.18.pdf",2018,Michael O. Moore,,Massachusetts Legislature,"20-18-4077 RECEIVED ST ATE ETHICS COMMISSION 2018 AUG 10 AM 10: 36 Amended OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected Michael O. Moore public employee: Title/ Position State Senator Agency/ Department Massachusetts Legislature Agency address: Room 109B, State House, Boston, MA 02133 Office phone: 617-722-1485 Office e-mail: Michael.Moore@MAsenate.gov Write an X to I am filing this disclosure because: confirm each statement. _xx_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and XX A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity I was invited to a Teacher Licensing Seminar exploring teacher which is the reason licensure portability and reciprocity for the states of the ERC. This for traveling. seminar is scheduled for the afternoon of Friday, August 3rd and the morning of Saturday, August 4th prior to the start of the ERC Legislative Conference, in Rye Brook, NY. Increasingly states are looking at how to address teacher shortages. One strategy identified at the 2017 ERC Annual Meeting is to explore the feasibility of a teacher licensing/certification interstate compact. Interstate occupational licensure compacts have been used in recent years to foster greater licensure portability for professionals in the medical professions, namely physicians, nurses and physical therapists. What benefits would this mechanism provide for students, teachers, and the states of the Eastern Region Conference states (ERC)? What is the current landscape for teacher reciprocity in the ERC? What benefits are states now receiving from licensure reciprocity and what barriers exist? How would military spouses benefit from greater ease of mobility for teachers? And can we reach a consensus on the problem and chart a path forward to begin exploring remedies? These are some of the topics we will examine with attendees. This Seminar will further examine teacher licensing practices in the ERC, the current rules of teacher licensure mobility, opportunities for creating interstate mechanisms for licensure portability as well as examining the challenges for policy makers and ways state leaders can address these obstacles. ERC of The Council of State Governments' National Center for Interstate Compacts will be in attendance to share their experience and expertise as well as engage with ERC members in thoughtful discussions of the issues surrounding enhanced teacher licensing portability and reciprocity. Describe your I will be moderating a panel regarding teacher Licensure portability and participation in the reciprocity. activity. Date, time and August 3-6, 2018 location of activity. Please explain how the As a State Senator and the Chairman of the Committee on Higher Education, I activity will promote the am often provided the opportunity to attend forums relative to education and interests of the Higher Education and their relationship with opportunities to establish or expand Commonwealth, a economic development. This training will provide me with the proper protocols on county or a municipality. building upon these opportunities. TRAVEL EXPENSES Identify the person or Dan Logsdon, National Center for Interstate Compacts organization that The Council of State Governments offered to reimburse, 2760 Research Drive, Lexington, KY 40511-8482 waive or pay your travel expenses. Address of person or The Council of State Governments organization. 2760 Research Drive, Lexington, KY 40511-8482 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: Airfare is $146.39, plus taxi fare $181.70 Overnight accommodations. Lodging: Each night of hotel is $156.00 plus tax ($468.00) Breakfast, lunch, dinner, special events. Meals: Included in subsidy and my costs.. $80.72 Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Included in subsidy and my costs. Other (please list): Refreshment, instruction, materials, entertainment, etc. Other (please list): Included in subsidy and my costs. Total: $1324.28 Write an X beside any XX I have attached the relevant itinerary. relevant statement. XX I have attached the relevant agenda. For the exemption Having disclosed the facts above, I determine that: to apply, check off XX Acceptance of the reimbursement, waiver or payment of travel expenses will serve both statements. a legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county or a municipality; AND XX Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Meath Date: 7/30/18 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission."
022f09c43e1989fce39cd909a3bc8f8c20f81daa35bee21d53f3004374eb823f,2013/WinslowresignationDisc9.16.13.pdf,2013,,,,"The Commonwealth of Massach RECEIVED STATE ETHICS COMMISSION House of Representatives 2013 SEP 16 AM 08 State House, Boston 02133- 1054 COMMITTEES ON: DANIEL B. WINSLOW Judiciary STATE REPRESENTATIVE Rules 9TH NORFOLK DISTRICT State Administration and Oversight STATE HOUSE ROOM 33 TEL (617) 722-2060 September 16, 2013 FAX (617) 722-2849 BY HAND Steven James, Clerk House of Representatives State House, Room 145 Boston, Massachusetts 02133 RE: Resignation Dear Mr. Clerk: With deep regret, I ask that you please accept this letter as notice of my resignation from the Massachusetts House of Representatives, effective at 12:00 noon on September 29, 2013. Effective Monday, September 30, I will return to the private sector on a full-time basis as the Senior Vice President & General Counsel of Rimini Street, Inc. (""RSI"") working in the company's Operations Center in San Francisco's East Bay. I am informed that RSI does not currently have any business transactions with the Commonwealth of Massachusetts or its political subdivisions, but I will recuse myself from any legislative matters in involving RSI in the unlikely event any arise before the effective date of my resignation. By copy of this letter, I wish to convey my sincere thanks to the Speaker and my Leader for their many kindnesses during my service. I hope that my actions and ideas as a Representative have brought honor to the House. I will miss every one of my colleagues and wish them all well in their efforts. Special thanks to you, Mr. Clerk, your able staff, the court officers and House staff for making my service as productive and enjoyable as possible. I have loved every minute of the honor of service as Representative of the people of the 9th Norfolk. I will maintain my legal residence in Massachusetts, where my family has lived since 1620, so I hope that our paths cross in public service in the future. Respectfully, ca: Hon Robert DeLeo, Speaker Hon. Bradley Jones, Minority Leader Hon. William F. Galvin, State Secretary Deirdre Roney, Esquire, State Ethics Commission House Personnel Office"
02302fa4a7399bad7db2d72f6a2f76553237bf94a92fe60ded9d0d37937da7f7,2016/SwanBenjamin4.13.16.pdf,2016,,,,"20- DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. c. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public Benjamin Swan official: Public official State Representative position: Public office State House, Room 238 address: Office Phone: 617-722-2380 Office E-mail: Benjamin.Swan@mahouse.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in the development, debate and to be taken: enactment of the Fiscal Year 2017 General Appropriations Act. House 2, the governor's budget proposal, includes language that would increase the annual employee contribution amount from 20% to 25% for state employees who were hired before July 1, 2003 and who receive health insurance through the Group Insurance Commission, and I anticipate that similar proposals may be made over the course of budget deliberations. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it involved: I have been a state employee since before July 1, 2003 and I receive health insurance though the Group Insurance Commission. Therefore, if enacted, this proposal would increase the amount of my annual contribution for health insurance. Public official's signature: Date: 4/13/2016 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
023bb40c51949883aa84445c2443dc4ab83b322179dfd60b1c5bf990bd07a673,2013/Abbate-Vaughn.pdf,2013,Jorgelina Abbate-Vaughn,,,"DISCLOSURE BY SPECIAL STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT STATE RECEIVEDMISSION AS REQUIRED BY G. L. c. 268A, 2013 DEC 10 AM IO: 39 SPECIAL STATE EMPLOYEE INFORMATION Name of special Jorgelina Abbate-Vaughn state employee: I am a special state employee because: Put an beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state 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 state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Associate Professor Fill in this box If you are a special state employee because a state agency has contracted with your company or if it applies to you. organization, please provide the name and address of the company or organization. State Agency/ This is ""my State Agency."" Department: University of Massachusetts Boston, Department of Curriculum and Instruction Agency Address: 100 Morrissey Boulevard. Boston, MA 02125 Office phone: (617) 287-7609 Office e-mail: jorgelina.abbate@umb.edu Check one: Elected or Non-elected Starting date as a September 2004 special state employee. BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee. Select either STATEMENT #1: I had a financial interest in a contract made by a state agency before I was STATEMENT #1 or elected to a compensated special state employee position. I will continue to have this financial STATEMENT #2. interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an A compensated, non-elected position with a state agency. by your financial A contract between a state agency and myself. interest. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). Select either STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an STATEMENT #1 or employment contract, before I took a non-elected, compensated special state employee position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the ""contracting agency."" Name and address of state agency that Massachusetts Department of Elementary and Secondary Education (MADESE)- 75 Pleasant Street. Malden, MA 02148-4906 made the contract Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX Contracts between MADESE and myself: 13ELADN4 and 13ELAPA2 are both as ""RETELL instructor"" (for school administrators and teachers respectively). MADESE's RETELL initiative is meant to train working school staff in Sheltered English Instruction strategies. ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND ANOTHER PERSON OR ENTITY - Please identify the person or entity that has the contract with the state agency. - What is your relationship to the person or entity? - What is the contract for? What is your - Please explain the financial interest and include the dollar amount if you know it. financial interest RETELL instructors are paid varying amounts that range between $1,800.00 and $5,000.00 in the state contract? depending on the duration and scope of the course taught. Date when you 7/30/2013 (13ELADN4) and 9/19/2013 (13ELAPA2) acquired the financial interest What is the financial - Please explain the financial interest and include the dollar amount if you know it. interest of your immediate family? Date when your immediate family acquired the financial interest Employee signature: Jen Date: 12/4/2013 Attach additional pages if necessary. File your completed, signed Disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
025c0a076551a757fb7b54b06aee1e93925fe5727876a35ddcf0cfe3147a4aef,"2018/Forest,_James_6.20.18_-_6_Cv_Ltr.pdf",2018,,,,"University Crossing 220 Pawtucket Street, Suite 480 RECEIVED И Lowell, MA 01854-3573 STATE COMMISSION University of tel: 978-934-2168 Massachusetts UMASS Lowell 2018 JUN 20 AM : 11 Learning with Purpose OFFICE OF THE PROVOST AUTHORIZATION LETTER FROM PROVOST June 11, 2018 Dr. James Forest School of Criminology and Justice Studies 19 Quaker Lane Dover, NH 03820-4916 Re: Use of Textbook for Teaching and M.G.L. c.268A, §6 - Title: The Terrorism Lectures (3rd Edition) Dear Dr. Forest, Thank you for your recent request to assign the above referenced textbook you have written to students in your courses. An ethical conflict of interest is created by any personal financial benefit that may ensue from actions that you make in your professional capacity as a state employee; such as the financial gain that you might incur from sales of a textbook that you assign UMass Lowell students to purchase who are attending courses you teach. In reviewing your request, I conclude that your financial interest in the textbook selection decision is not so substantial as to affect the integrity of your service to the Commonwealth. Accordingly, I approve your request to assign this textbook for the Fall 2018 semester. Please retain this written determination for your records. Sincerely, Michael E. Vayda, Ph.D. cc. State Ethics Commission (copied pursuant to requirement of §6) Donna Mellen, Associate Director, Academic Technology"
025efbbc973a82815e0f22368a7e835eb5412360051ac298494203d3a08c528d,2017/GrayCarruthersKaren1.3.17.pdf,2017,Karen Gray Carruthers,,,"DISCLOSURE BY STATE EMPLOYEE OF A FINANCIAL INTEREST IN A CONTRACT WITH THE DEPARTMENT OF CHILDREN AND FAMILIES AS REQUIRED BY 930 CMR 6.05(2)(b) RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name of state 2017 JAN 3 PM 12: 39 employee: Karen Gray Carruthers Title/ Position Administrative Magistrate Agency: Department of Public Health Bureau of Health Professions Licensure Agency address: 239 Causeway Street, Suite 500, 5th Floor Boston, MA 02114 I am a state employee, and I also have agreed to serve as a foster parent, guardian, or pre-adoptive or adoptive parent, or to serve in a comparable status. The Department of Children and Families (""DCF"") has a contract or agreement with me or with another person or organization relating to the service I am providing. I am disclosing that I receive financial benefits and/ or have financial obligations because of the contract or agreement made by DCF. FINANCIAL INTEREST IN A DCF CONTRACT I have an agreement to serve as: Foster parent; Guardian; Please write an X beside your answer. Pre-adoptive parent; Adoptive parent; Other. Please explain. . My agreement is with: Please write an X DCF directly; beside your answer, and provide any A person or organization that has a contract with DCF. requested information. - Please provide the name and address of the person or organization. PLEASE DO NOT PROVIDE INFORMATION BELOW ABOUT THE IDENTITY OF THE CHILD. Please refer to the child as ""the child"" or ""the foster child,"" etc. In the answers below, please provide a dollar amount, if possible. Please identify any Do you receive, e.g., a subsidy or benefits, compensation, reimbursement of expenses, or a financial benefit you clothing allowance? receive because of your service. We anticipate receiving the standard subsidy, reimbursement of expenses and clothing allowance as deemed appropriate by DCF. Who provides these financial benefits to The financial benefits will be provided by DCF. you? Include the name and address. Massachusetts Department of Children and Families 600 Washington Street Boston, MA 02111 Arlington Area Office 30 Mystic St. Arlington, MA 02474 (781) 641-8500 Please identify any Did you agree to accept any financial obligation, e.g., to maintain homeowner's insurance? financial obligation you have accepted in No. (We already maintain homeowner's insurance.) connection with this service. Employee signature: KCgC Date: January 3, 2017 Attach additional pages if necessary. File copy with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012"
027312b3801d1519a6323fa5dec9c760dbbefde916d83051dec071d4ed326989,"2017/deMacedo,_Viriato_5.23.17_-_6A.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION AS REQUIRED BY G. L.c. 268A, PUBLIC OFFICIAL INFORMATION 2017 MAY 23 PM 3:21 Name of public official: Sendtor Viriato M. de Macedo Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1330 Office E-mail: I vinny.delhoole@maynoke.go am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the fiscal year to be taken: 2018 budget. One issue to be considered is whether the budget should include an outside section which would change the General Laws and cap the deductible and copayments for covered services during an enrollment year for those who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I I receive have health Mady insurance disclosed the that Insurance though Group Commission. Action on the budget with Kg disclose that my brother receives would affect the amount of my out of pocket health insurance/expenses. I also Public official's signature: his Malk insurance through the GIC. Date: deMarb 5/23/17 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
027489bca5da2310896d6e1a9449cfc41cf2f587c8f19ef71de538abed27c211,"2015/L'Italien,_Barbara_930CMR5.082d2_disclosure_2015-10-05.pdf",2015,2015 OCT - 5 PH 2:56,,State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. RECEIVED STATE ETHICS COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected Barbara L'Italien 2015 OCT - 5 PH 2:56 public employee: Title/ Position State Senator Agency/ Department State Senate Agency address: State House, Room 413C Boston, MA 02133 Office phone: 617-722-1612 Office e-mail: Barbara.L'ltalien@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for traveling. To attend a Women in Government Eastern Leadership Conference Describe your participation in the Participating in the conference as a woman legislator. The meeting will convene activity. women state legislators throughout both regions to discuss cutting-edge public policy issues. Topics will include diabetes, energy, the environment, education, economic development, and more. Date, time and location October 7-10th, 2015 of activity. Please explain how the The meeting will convene women state legislators throughout both regions to discuss activity will promote the cutting-edge public policy issues. Topics will include diabetes, energy, the interests of the environment, education, economic development, and more. This conference will help Commonwealth, a county or a municipality. share ideas for better government and policy solutions for the Commonwealth. TRAVEL EXPENSES Identify the person or organization that offered to reimburse, Women in Government waive or pay your travel expenses. Address of person or organization. 1319 F Street, NW Suite 710 Washington, DC 20004 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Transportation: Lodging: $427.65 Meals: $100 (estimate) Admission: Other (please list): Total: $527.65 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement. waiver or payment. Employee signature: Date: 10/5/15 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 WOMEN OVERNMENT Advanced Technology & Innovations Summit Wednesday, October 7 - Thursday, October 8, 2015 16th Annual Southern & 17th Annual Eastern Regional Conferences Thursday, October 8, 2015 - Saturday, October 10, 2015 Francis Marion Hotel, Charleston, South Carolina *SCHEDULE OF EVENTS** Advanced Technology & Innovations Summit Wednesday, October 7 Registration 2:00pm - 6:00pm Carolina Ballroom B Foyer, Meeting Level General Session 4:00pm - 6:00pm Carolina Ballroom B, Meeting Level Welcome Reception 6:30pm - 7:00pm Carolina Ballroom A, Meeting Level Welcome Dinner 7:00pm - 9:00pm Carolina Ballroom A, Meeting Level Thursday, October 8 Breakfast Share 7:45am - 8:45am Carolina Ballroom A, Meeting Level Registration 7:45am - 4:00pm Carolina Ballroom B Foyer, Meeting Level General Session 9:00am - 4:00pm Carolina Ballroom B, Meeting Level Luncheon 12:00pm - 1:15pm Carolina Ballroom A, Meeting Level Southern & Eastern Regional Conference Thursday, October 8 Registration 5:00pm - 7:00pm Carolina Ballroom B Foyer, Meeting Level Optional Documentary Screening 5:00pm - 6:30pm Carolina Ballroom B, Meeting Level Welcome Reception 6:30pm - 7:00pm Carolina Ballroom A, Meeting Level Welcome Dinner 7:30pm - 9:00pm Carolina Ballroom A, Meeting Level Friday, October 9 Optional Humane Society Walk 7:00am - 7:45am Marion Park *We will meet in the hotel lobby at 7:00am for a group walk. Optional Humane Society Meet & Greet 7:45am - 8:15am Marion Park Breakfast 7:15am - 8:15am Carolina Ballroom A, Meeting Level Registration 7:15am - 3:45pm Carolina Ballroom B Foyer, Meeting Level General Session 8:30am - 3:45pm Carolina Ballroom B, Meeting Level Luncheon 12:00pm - 1:00pm Carolina Ballroom A, Meeting Level Beverage Break & Tasting 1:00pm - 1:15pm Carolina Ballroom B Foyer, Meeting Level FWIG Roundtable Discussion 3:45pm - 4:45pm Laurens Room, Meeting Level Post Conference Unwind 4:30pm - 6:00pm Carolina Ballroom A, Meeting Level SC State Night Dinner 6:00pm - 9:30pm Mt. Pleasant Visitors Center *We will meet in the hotel lobby at 6:00pm for a group departure. 9/29/15"
02752df428a86d8516acbd5fe7ebd98300e7ae388b16f0fdcd3ea5e00e10277a,2022/Sachs_Elka_8.8.22_7(d).pdf,2022,Elka Sachs,,,"RECEIVED STATE ETHICS COMMISSION DISCLOSURE BY SPECIAL STATE EMPLOYEE 2022 AUG - 8 AN IO: 13 OF FINANCIAL INTEREST IN A STATE CONTRACT AS REQUIRED BY G. L. c. 268A, § 7(d) SPECIAL STATE EMPLOYEE INFORMATION Name of special Elka Sachs state employee: I am a special state employee because: Put an X beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state 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 state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Partner at Krokidas & Bluestein, representing state agencies listed on Attachment A. If you are a special state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Krokidas & Bluestein, 600 Atlantic Avenue, Boston, MA 02210 State Agency/ This is ""my State Agency."" Department: See Attachment A Agency Address: See Attachment A Office phone: 617-482-7211 Office e-mail: ets@kb-law.com Check one: Elected or Non-elected Starting date as a special state See Attachment A employee. BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee. N/A STATEMENT #1: I had a financial interest in a contract made by a state agency before I was Select either elected to a compensated special state employee position. I will continue to have this financial STATEMENT #1 or interest in a state contract. STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. Write an A contract between a state agency and myself. by your financial interest. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an Select either employment contract, before I took a non-elected, compensated special state employee STATEMENT #1 or position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the ""contracting agency."" Name and address of state agency that See Attachment A and B made the contract Write an to confirm in my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX N/A"
0287b3241ced0fcb9fd8b58ac865d6ccff53eae4ad392a80578a863a244ad770,2014/MooreMichael_12.08.14.pdf,2014,Senator Michael Moore,,,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF EXPENSES RELATED TO ATTENDANCE AT AN EVENT SERVING A LEGITIMATE PUBLIC PURPOSE STATE ETHICS RECEIVED COMMISSION AS REQUIRED BY 930 CMR 5.08(3)(b) 2014 DEC 8 AM 10: 10 ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Senator Michael Moore Title/ Position State Senator Office: ROOMIO9B Borton, MA 02133 State House Office address: Office phone: 617 722 1485 Office E-mail: Michael.Moore@masenate.sov I am filing this disclosure because: Write an X My attendance at an event will serve a legitimate public purpose, i.e., it will promote the to confirm each interests of the Commonwealth, a county or a municipality; and statement. A non-public entity (but not a lobbyist) has offered to pay or waive expenses worth more than $50 related to the event. EVENT ATTENDED Describe the event that you will attend. Chamker of commerce event to learn about The prionties of the chamber and business community. Describe your participation in the attending event. Date, time and location Dec 12 ,2014 of event. Noon DCU center woraster EXPENSES RELATED TO INCIDENTAL HOSPITALITY Identify the person or organization that worcester Regional chamber of commerce offered to reimburse, 446 Main st, Sulk 200 pay or waive expenses. worcester, mA 01608 Address of person or organization. Provide information Itemization and explanation of amounts offered: in as much detail as possible: Transportation: Air, train, bus, and taxi fare and rental car hire, etc. Meals: Breakfast, lunch, dinner, special events. Admission: Admission, tickets, etc. $55 Other (please list): Refreshment, entertainment, etc. Total: $55 Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., will promote the interests of the Commonwealth, a county or check off a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Please explain how the activity will promote the interests of the Commonwealth, a county or a municipality. Employee signature: Date: 12/4/14 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission® Elected municipal employee - file with the City Clerk or Town Clerk. MacNeill, Shelly (SEN) From: Stuart Loosemore <SLoosemore@WorcesterChamber.org> Sent: Wednesday, December 03, 2014 10:58 AM To: Moore, Michael O (SEN) Cc: MacNeill, Shelly (SEN) Subject: Worcester Regional Chamber of Commerce Annual Meeting Attachments: DISC 5 08(3) Event Expense Elected NEW.doc Follow Up Flag: Follow up Flag Status: Flagged Dear Senator Moore, The Worcester Regional Chamber of Commerce would like to invite you to the Worcester Regional Chamber of Commerce's 139th Annual Meeting to be held on FRIDAY, DECEMBER 12, AT 12:00 NOON AT THE DCU CENTER IN WORCESTER. The Agenda for the day is: 11:45 AM - Registration 12:00 PM - Luncheon 12:45 PM - Program 2:00 PM - Adjournment Our keynote speaker will be Dr. Laurie Leshin, President, Worcester Polytechnic Institute. Dr. Leshin is committed to elevating WPI's impact in communities worldwide and brings to WPI more than 20 years of experience as a leader in academia and government service, and an accomplished record as a space scientist. She combines a life-long love of learning and exploration with a strong track record of igniting action to advance critical institutions and programs. Our program will also include the election of New Officers and Directors and the President's Report; this is a tremendous opportunity to hear about the accomplishments of the Chamber over the last year and to learn more about our agenda for the coming year. Your attendance is complimentary. Given that the ticket price is $55, the Chamber contacted the State Ethics Commission regarding this issue, who advised us that there is an exemption from the prohibition against acceptance of gifts that permits public employees to accept incidental hospitality in the context of weekday informational events, where the public employee's attendance will serve a legitimate public purpose. It was the belief of the Ethics Commission that your attendance at our event, where you would learn about some of the priorities of the Chamber and Business Community, would indeed serve a legitimate public purpose and bring your attendance under the exemption. (Here is a link to the regulation creating that exemption, which is 930 CMR 5.08(3) - scroll to page 29 in the document.) http://www.mass.gov/ethics/laws-and-regulations/rules-and-regulations-governing-the- commission/#508:GiftsWorth50orMoreandRelatedtoOfficialActionorPosition:Exemptions If you do plan to attend you will need to file a disclosure form which we have attached for your convenience. On the form where it asks for information of the person or entity offering to pay for or waive the expense please list: Worcester Regional Chamber of Commerce 446 Main Street, Suite 200 Worcester, MA 01608 And the waived fee is to cover the cost of the lunch provided during your attendance. 1"
0289c3bff635f06340b209c9d6d033960bdb7a7a53cdfcb49df7939baac96965,"2017/Pignatelli,_Benjamin_8.7.17_-_6.pdf",2017,Benjamin Pignatelli,,DPU,"RECEIVED STATE ETHICS COMMISSION OVIETEM THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC UTILITIES 2017 AUG 7 AM11:01 CHARLES D. BAKER ONE SOUTH STATION ANGELA M. O'CONNOR GOVERNOR CHAIRMAN BOSTON, MA 02110 KARYN E. POLITO (617) 305-3500 ROBERT E. HAYDEN LIEUTENANT GOVERNOR COMMISSIONER MATTHEW A. BEATON CECILE M. FRASER SECRETARY OF ENERGY COMMISSIONER AND ENVIRONMENTAL AFFAIRS August 3, 2017 State Ethics Commission One Ashburton Place Room 619 Boston MA 02108 RE: Disclosure of Financial Interest To whom it may concern: Please find enclosed Disclosure By Non-Elected State Employee for Department of Public Utilities employee, Benjamin Pignatelli. The disclosure has been completed and signed by Mr. Pignatelli and signed by myself, Matthew Nelson, Director Electric Power Division. Sincerely, Matthew m/ MM Director, cc: Matthew Campbell, DPU Chief of Staff Laura-Jean Canducci, EEA HR Deputy Director FAX: (617) 345-9101 www.mass.gov/dpu DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITYHICS COMMISSION AS REQUIRED BY G. L. c. 268A, § 6 2017 AUG-7 AM11:01 STATE EMPLOYEE INFORMATION Name: Benjamin Pignatelli Title or Position: Economist State Agency: Department of Public Utilities Agency Address: 1 South Station, Boston, MA 02110 Office Phone: (617) 305-3673 Office E-mail: Benjamin.pignatelli@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter I have a professional interest, outside of my work at the Department, in proposing the formation of a regional smart grid consortium. E.g., a judicial or other proceeding. application, submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required I have reviewed grid modemization proposals before the Department. participation in the particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, Investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest I am uncertain whether I have a financial interest in this matter. in the matter I am looking to develop a regional effort to exchange information on smart grid technologies. If my idea is possible then I might have a financial interest if there is funding available. I have not spoken with any funders. Employee signature: Date: 3/2/17 By Pj atl DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Matthew lelson Title or Position: Director of Electric Power Agency/Department: DPU Agency Address: One South Station Boston MA, 02110 Office Phone: 617-305-3637 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, §6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: nf 8/2/107 1/2 Comment: There was confusion if this was already submitted - 50 I am resubmiting Furths there have been addtoral developments regarding other financial intrests by this employee which have been submitted. Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
02991bccfd69039ecb48b5591280a5212281b6eae278d6e715e70ac766ce3a9c,"2019/Hinds,_Adam_930CMR5.082d2_10.10.19.pdf",2019,Adam G. Hinds,,State Senate,"DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. RECEIVED TATE COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION 2010 OCT 10 2: 13 Name of elected public employee: Adam G. Hinds Title/ Position Senator Agency/ Department State Senate Agency address: State House, Room 109-E Boston, MA 02133 Office phone: 617 722 1625 Office e-mail: Adam.Hinds@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for I am attending the National Conference of State Legislature's 2019 Broadband and traveling. Cable Policy Summit. There will be a range of sessions to review best practices, trends and more related to rural high-speed internet. Describe your participation in the I will be participating in meetings, briefings and site visits. activity. Date, time and location of activity. October 14, 2019 to October 16, 2019. The Summit's events will take place at La Meridien Denver and in other locations around the city. Please explain how the Massachusetts is engaged in an ongoing, ten-year process to bring high-speed activity will promote the internet to unserved communities, a majority of which are in my district. I will use the interests of the information learned at this Summit to inform my work in the Senate and expand and Commonwealth, a county improve high-speed internet access and service in Massachusetts. or a municipality. TRAVEL EXPENSES Identify the person or organization that The National Conference of State Legislatures (NCSL) offered to reimburse, waive or pay your travel expenses. Address of person or organization. 444 North Capital Street, NW Suite 515 Washington, DC 20001 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: The flight from Hartford, CT to Denver, CO and back is $459.28. Overnight accommodations. Lodging: My stay at Le Meridien Denver is approximately $250.00 a night. I will be staying there for 4 nights, 1 of which I will be paying for myself and 3 for which I will be reimbursed due to my participation in the Summit. The total amount for which I will be reimbursed is approximately $750. Breakfast, lunch, dinner, special events. Meals: Breakfast and lunch will be provided, for a cost of approximately $250.00 Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): N/A Total: Approximately $1,459.28. I will submit a reconciliation form with the final amount once I have it. Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: alesk Date: 10/9/19 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. BROADBAND & CABLE SUMMIT 2019 Broadband & Cable Policy Summit Innovation, Investment and Infrastructure Le Meridien Denver - Grove Ballroom Monday, October 14, 2019 Prior to 2:00 pm Arrive Denver 2:00 pm Welcome, Overview and Goals 2:30 pm - 3:30 pm Session I - Broadband/Cable Top 10 - What You Need to Know 3:30 pm - 4:30 pm Session II - Tech Trends and Breakthrough Technologies 4:30 pm - 5:15 pm Session III - Smart Homes and Connected Communities: Industry Innovation and Investment 6:00 pm Opening Reception Tamayo Rooftop Terrace (Sunset at 6:22 pm) 1400 Larimer Street Tuesday, October 15, 2019 7:30 am - 8:15 am Breakfast 8:15 am - 9:00 am Session IV - Privacy: Protecting Consumers in the Internet Age 9:00 am - 10:00 am Session V - Connecting America: How Cable is Trailblazing a Path for Rural Broadband! 10:00 am - 10:45 am Session VI - Connecting America: The Role of the Pole 10:45 am - 11:30 am Session VII- Connecting America: Incenting Investment and Economic Development 11:45 am - 12:30 pm Travel to CableLabs 12:30 pm - 4:30 pm CableLabs Program Lunch & Future Trends in Technology and Innovation Technology Demonstrations Post-Demo Discussion & Wrap-up"
02a1626f055df1a716e30cd183eab6fd5bc32d8e5265401625d74bb48768f138,"2013/Walsh,_Steven_section_23_disclosure_2013-02-06.pdf",2013,,,,"The Commonwealthohassachusetts ENSE PETIT OVIETEM HOUSE QA STATE HOUSE, BOSTON 02133-1054 MOLIMENTATE 2013 FEB -6 PM 4:41 STEVEN M. WALSH Chairman STATE REPRESENTATIVE Health Care Financing 11TH ESSEX DISTRICT ROOM 236, STATE HOUSE E-Mail: Steven.Walsh@MAhouse.gov TEL. (617) 722-2430 FAX. (617) 722-2436 February 6, 2013 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 To Whom It May Concern: I am writing to you pursuant to G.L. c 268A §6 and 23(b)(3) to disclose that I am today submitting my résumé to Catlin Donnelly, Consultant and Recruiter, in order to apply for the position of President of Blue Cross Blue Shield of Massachusetts Foundation, Inc. Until an applicant is chosen as said President, I will not participate in any matters in which either Blue Cross Blue Shield Foundation or its affiliate organization Blue Cross Blue Shield of Massachusetts has an interest. Sincere Steven M. Walsh State Representative 11th Essex District"
02a7acdf4315aa09f265d944b73ece14f47a3b1d170cd8bb4a95ff6528252019,2014/Dortch-OkaraRedacted(10-13-0208)1.16.14.pdf,2014,Barbara A. Dortch-Okara,,State Ethics Commission,"REDACTED DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L. c. 268A, § 23(b)(3) PUBLIC EMPLOYEE INFORMATION Name of public employee: Barbara A. Dortch-Okara Title or Position: Chair REDACTED Agency/Department: State Ethics Commission Agency address: 1 Ashburton Place, Rm 619, Boston MA 02108 Office Phone: (617) 371-9500 Office E-mail: n/a In my capacity as a state, county or municipal employee, I am expected to take certain actions in the performance of my official duties. Under the circumstances, a reasonable person could conclude that a person or organization could unduly enjoy my favor or improperly influence me when I perform my official duties, or that I am likely to act or fail to act as a result of kinship, rank, position or undue influence of a party or person. I am filing this disclosure to disclose the facts about this relationship or affiliation and to dispel the appearance of a conflict of interest. APPEARANCE OF FAVORITISM OR INFLUENCE Describe the issue Matter No. 10-13-0208 that is coming before you for action or decision. What responsibility Discuss and vote on whether to permit Enforcement Division to amend preliminary inquiry. do you have for taking action or making a decision? Explain your I know the respondent in this matter professionally, but the respondent is not a friend or relationship or social acquaintance. affiliation to the person or organization. How do your official The affected person is the respondent in an Enforcement matter. actions or decision matter to the person or organization? Optional: Additional facts - e.g., why there is a low risk of undue favoritism or improper influence. WRITE AN X TO CONFIRM THE STATEMENT BELOW. If you cannot confirm this statement, you should Taking into account the facts that 1 have disclosed above, I feel that I can perform my recuse yourself. official duties objectively and fairly. Employee signature: Date: January 16, 2014"
02ac0da05f30ec6f1c74d0e4ba350d24b2aa35a09e66d7dadfe3bd1a12dcd67f,"2017/Brady,_Michael_5.22.17_-_6.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6AST ATE ETHICS RECEIVED COMMISSION PUBLIC OFFICIAL INFORMATION Name of public Michael D. Brady 2017 MAY 22 PM 4:09 official: Public official Massachusetts State Senator position: Public office The State House Room 519 address: Boston, MA 02133 Office Phone: 617-722-1200 Office E-mail: Michael.brady@masenate.gov I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the fiscal year to be taken: 2018 budget. One issue to be considered is whether the budget should include an outside section which would change the General Laws and cap the deductible and copayments for covered services during an enrollment year for those who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: 1 receive health insurance though the Group Insurance Commission. Action on the budget would affect the amount of my out of pocket health insurance expenses. Public official's signature: Date: mechal 5/22/17 J. Brady Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
02c32758063198a0b8723acc9d5ed17852bd8841d136b70b488278f42900399b,"2016/Pacheco,_Marc_section_6A_disclosure_7.22.16.pdf",2016,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN RECEIVED AS REQUIRED BY G. L. C. 268A, § 6A STATE ETHICS COMMISSION PUBLIC OFFICIAL INFORMATION 2016 JUL 22 PM 3:33 Name of public Marc R. Pacheco official: Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1551 Office E-mail: Marc.Pacheco@masenatte.gov. I am filing this disclosure because I am a public official and, in the discharge of my official duties, 1 am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the Governor's to be taken: actions with respect to the fiscal year 2017 budget. One issue to be considered is whether the budget should include language that would change the Commonwealth's health insurance contribution for active state employees who were hired before July 1, 2003 and who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I have been a state employee before July 1, 2003 and I receive health insurance though the Group Insurance Commission. Action on the Governor's proposed change would affect the amount of my annual contribution for health insurance. Public official's signature: Mare X, RL Date: 7/21/2016 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
02cd9d499eaed75ba655f67aac1e3591fcd87b3f6d02883d6add92dc4c1e5f80,"2017/Fattman,_Ryan_section_6A_disclosure_5.23.17.pdf",2017,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6ARECEIVED ST TE ETHICS COMMISSION PUBLIC OFFICIAL INFORMATION Name of public 2017 MAY 23 AM : 50 official: Senator Ryan C. Fallman Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1420 Office E-mail: I am ryam.VaHnan@nasernate.gov filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the fiscal year to be taken: 2018 budget. One issue to be considered is whether the budget should include an outside section which would change the General Laws and cap the deductible and copayments for covered services during an enrollment year for those who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I receive health insurance though the Group Insurance Commission. Action on the budget also would affect receives the amount her of my marth out of pocket health insurance insurance expenses. My wite through the GIC Her expenses would be Public official's signature: oneakat 15th m the same way. Date: 5-23-17 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE-TAKEN AS REQUIRED BY G. L.c. 268A, § STATE ETHICS COMMISSION PUBLIC OFFICIAL INFORMATION 2017 MAY 23 AM11:51 Name of public official: Senator Jenniter L. Flanagan Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1230 Office E-mail: jnathr.Mangon@marenale.go I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the fiscal year to be taken: 2018 budget. One issue to be considered is whether the budget should include an outside section which would change the General Laws and cap the deductible and copayments for covered services during an enrollment year for those who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I receive health insurance though the Group Insurance Commission. Action on the budget would My sisker affect the amount also of receives my out of pocket health health insurance insurance expenses. through Ake 6IC. Public official's signature: Date: Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. c. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6A RECEIVED STATE ETHICS COMMISSION PUBLIC OFFICIAL INFORMATION Name of public official: ANNE M. Gobl 2017 MAY 23 PM 3: 10 Public official Massachusetts State Senator position: Public office The State House address: Boston, MA 02133 Office Phone: 617-722-1540 Office E-mail: Anne.Gobiemasenate.gv Anne. Gobie masenate. I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action I intend to discuss, vote on, and otherwise participate in consideration of the fiscal year to be taken: 2018 budget. One issue to be considered is whether the budget should include an outside section which would change the General Laws and cap the deductible and copayments for covered services during an enrollment year for those who receive health insurance through the Group Insurance Commission. FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I receive health insurance though the Group Insurance Commission. Action on the budget would affect the amount of my out of pocket health insurance expenses. Public official's signature: are M. Gabi Date: 5-22-17 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
02e41b258c3fe6d103481416915f50f40b98bb880a381aecd50110fbabb03a57,"2025/Orel,_Joshua_section_7_disclosure_4.1.2025.pdf",2025,Joshua Ezra Orel,,,"DISCLOSURE BY SPECIAL STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AS REQUIRED BY G. L. c. 268A, § 7(d) SPECIAL STATE EMPLOYEE INFORMATION Name of special Joshua Ezra Orel state employee: I am a special state employee because: Put an beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state 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 state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Adjunct Professor If you are a special state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. State Agency/ This is ""my State Agency."" Department: Bunker Hill Community College Agency Address: 250 New Rutherford Ave Boston Office phone: 508-808-5473 (I do not have an office. This is my cell phone number.) Office e-mail: Joshua.orel@bhcc.edu Check one: Elected or Non-elected Starting date as a 9/3/2024 was the date I signed my employment contract. special state employee. BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee. Select either STATEMENT #1 or STATEMENT #1: I had a financial interest in a contract made by a state agency before I I was elected to a compensated special state employee position. I will continue to have this financial STATEMENT #2. interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an A compensated, non-elected position with a state agency. by your financial interest. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). Select either STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an employment contract, before I took a non-elected, compensated special state employee STATEMENT #1 or position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the ""contracting agency."" Name and address of state agency that made the contract Framingham State University Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for. THE NEXT BOX Position as a Culinary Workshop Instructor with the John c Stalker Institute at Framingham State University. This is a contracted position paid by the hour. ANSWER THE QUESTIONS IN THIS BOX"
02e499e17a6ef3ff19034f4ee6de325f3eeb20535599c2f9e482da44ae84db54,"2017/Horgan,_Julie_8.24.17_-_CMR_6.07.pdf",2017,Julie Horgan,,DMH,"%S6=8 Page ID:ETHICS-COMMISION From: AUG-24-2017 12:45 PM xDISCLOSURE BY STATE EMPLOYEE IN A CONTRACT TO PROVIDE PURSUANT TO 930 CMR 6.07 2017 AUG 24 PM COMMISSION 3:32 STATE EMPLOYEE INFORMATION Name of state Julie Horgan employee: Title/ Position: Clinical risk manager Agency/Department: DMH Agency Address: Solomon Carter Fuller 85 East Newton St. Boston, MA Office phone: 617-305-9911 Office e-mail Julie.Horgan@Massmail.state.ma.us I am a state employee, and I seek to have a financial interest in a contract or agreement made by a state agency listed below, or by a provider or organization funded by a state agency listed below: A state agency within the following Executive Offices: Executive Office of Health and Human Services, including the Human Service Transportation Office; Executive Office of Public Safety and Security, Executive Office of Elder Affairs, Executive Office of Veteran's Services, or A sheriff's office. The purpose of the contract is: To provide personal services to a person or persons who receive services from, or have services paid for by, these state agencies; or To provide educational services to people who work for these state agencies or for providers or organizations funded by these state agencies. I seek approval of the arrangement from the agency for which I serve as a state employee and from the state agency above that made the contract. FINANCIAL INTEREST IN A CONTRACT WITH A STATE AGENCY PLEASE CHECK OFF ONE OF THE THREE STATEMENTS BELOW AND PROVIDE THE REQUESTED INFORMATION. 1) Service to a state agency I will provide personal or educational services to a state agency listed above. Please identify the state agency and also the Executive Office it is in, if applicable. ? 'd 8778 °N Aug. 24. 2017 12:40PM R=95% Page:003 From: AUG-24-2017 12:45 PM 2) Service to a provider or I will provide personal or educational services to a provider or organization funded by a state organization agency listed above. Please provide the name and address of the provider or organization. Please identify the state agency that funds the provider or organization, and also the Executive Office it is in, if applicable. 3) Service to a person or persons I will provide personal services directly to a person or persons who receive services from, or have services paid for by, a state agency listed above. Please identify the state agency that provides services to, or pays for services for, the person or persons, and also the Executive Office it is in, if applicable. The BEST Team is funded by DMA, Dept. of Medical Assistance, and MBHP(a form of Mass Health). Please describe the Please provide information about the type of personal or educational services you will provide. services you will Please do not include the name of any individual who receives services. provide. I would be going to emergency rooms such as Carney Hospital and Children's Hospital and assessing people who are in psychiatric crisis. These are people who might be suicidal, psychotic, and/or unable to care for themselves. I would make a determination about what services they need-such as psychiatric unit or outpatient services. Some of these people will be DMH clients. What will you be The pay is ?$25.60 an hour. I'm looking to work 2 weekend days a month. paid, or what other financial interest will you have? Employee signature Date: 8/9/2017 Jah Holye APPROVAL BY AGENCY YOU SERVE AS A STATE EMPLOYEE Name and title of appointing authority Office phone Patricin Kenny - DMH Aren Director, Metro Boston E 'd 6878 No. Aug. 24. 2017 12:40PM R=95% Page:004 IDETHCS-COMMISION From: AUG-24-2017 12:45 PM Office e-mail Signature by By that I have reviewed the facts that the state employee has signing here, I indicate Kenny state. US appointing authority disclosed above and approve the arrangement proposed by the state employee. Date: (Patricin Kennef 8/21/17 APPROVAL BY AGENCY THAT MADE THE CONTRACT (IF DIFFERENT) Name and title of person giving approval at the state agency that made the contract Office phone Office e-mail Signature by person By signing here, I indicate that I have reviewed the facts that the state employee has giving approval disclosed above and approve the arrangement proposed by the state employee. Date: Attach additional pages if necessary. File with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012 1 di 6878 *ON Aug. 24. 2017 12:40PM"
02e4c1d332e2ab39d43fcfc31080f0a666b82ad803d60a54dfc295dcee0d1d80,"2019/Tan,_DavidV._5.21.19_-_7(b).pdf",2019,David V Tan,,Division of Capital Asset Management and Maintenance (DCAMM),"DISCLOSURE BY STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT AND CERTIFICATION BY HEAD OF CONTRACTING AGENCY AS REQUIRED BY G. L. c. 268A, § 7(b) ETHICS ED COMMISSION STATE EMPLOYEE INFORMATION 2019 21 PA Name of state David V Tan 2:29 employee: Title/ Position Office Support Specialist II If you are a state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Agency/ Department Division of Capital Asset Management and Maintenance (DCAMM) Agency Address John W McCormack Building One Ashburton Place 14 Floor Room 1411 Boston MA 02108 Office phone: (857) 204 - 1878 Office e-mail: David.Tan@mass.gov Check one: Elected or Non-elected Starting date as a 04/14/2019 state employee. ELECTED, COMPENSATED STATE EMPLOYEE BOX # 1 I am an elected, compensated state employee, other than a state Senator or a state Representative. Select either STATEMENT #1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I was elected to my compensated state employee position. I will continue to have this financial interest in a state contract. OR STATEMENT #2. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. Write an My financial interest in a state contract is: beside your financial interest. I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. NON-ELECTED, COMPENSATED STATE EMPLOYEE BOX # 2 I am a non-elected, compensated state employee. Select either STATEMENT # 1: I had one of the following financial interests in a contract made by a state STATEMENT #1 or agency before I took a position as a non-elected state employee. I will continue to STATEMENT #2. have this financial interest in a state contract. My financial interest in a state contract is: Write an X beside your A state agency has a contract with me, but not an employment contract. financial interest. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. -- OR STATEMENT # 2: I will have a new financial interest in a contract made by a state agency. My financial interest in a state contract is: I have a non-elected, compensated state employee position. A state agency has a contract with me. I have a financial benefit or obligation because of a contract that a state agency has with another person or an entity, such as a company or organization. I work for a company or organization that has a contract with a state agency, and I am a ""key employee"" because the contract identifies me by name or it is otherwise clear that the state has contracted for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT Name and address of state agency that MassHealth 100 Hancock Street made the contract 6th Floor Quincy, MA 02171 ""My State Agency"" is the state agency that I serve as a state employee. The ""contracting agency"" is the state agency that made the contract. Please put in an X My State Agency is not the contracting agency. to confirm these facts. My State Agency does not regulate the activities of the contracting agency. In my work for my State Agency, I do not participate in or have official responsibility for any of the activities of the contracting agency. The contract was made after public notice or through competitive bidding. ANSWER THE QUESTION IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND YOU. FILL IN - Please explain what the contract is for. THIS BOX OR THE BOX BELOW ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AND ANOTHER PERSON OR ENTITY. - FILL IN Please identify the person or entity that has the contract with the state agency. Nu Dam Tan What is your relationship to the person or entity? Son THIS BOX What is the contract for? I am my mother's CPA and she is living with me in the same household. OR THE BOX I get paid by her benefit provider Senior Whole Health. ABOVE"
02e67777d6193fbb6735d680c39bbacb0706d4bdb97c2b9c7e7e0fc7138863bb,"2020/Velis,_John_section_6A_disclosure_7.1.20.pdf",2020,,,,"DISCLOSURE BY A PUBLIC OFFICIAL (as defined by G.L. C. 268B, § 1) OF A FINANCIAL INTEREST IN AN ACTION TO BE TAKEN AS REQUIRED BY G. L. C. 268A, § 6A PUBLIC OFFICIAL INFORMATION Name of public John C. Velis official: Public official position: State Senator for the 2ⁿᵈ Hampden and Hampshire Public office address: Statehouse, Room 70 Office Phone: (413) 572 3920 Office E-mail: john.velis@masenate.gov. I am filing this disclosure because I am a public official and, in the discharge of my official duties, I am required to take an action which would substantially affect my own financial interests. I recognize that the action will have a greater effect on me than on the general public or on other state employees. I understand that after I disclose my financial interest, I may take the action. ACTION TO BE TAKEN Official action The Senate will be considering S 2789 on July 2, 2020. Amendment 20 to that bill would to be taken: establish bonuses for certain service in the military for which I may be eligible and I may have to vote on the amendment FINANCIAL INTEREST IN ACTION TO BE TAKEN Financial interest Please explain the financial interest and include the dollar amount if you know it. involved: I may be eligible for a bonus established by amendment 20 for S 2789 Public official's signature: John [ Velis Date: July 1, 2020 Attach additional pages if necessary. File the signed disclosure with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012"
03096cf276456fed28a55b1482ba5b64af7bc9e3772abb6401b15a43a40809f5,2016/SpilkaKaren12.9.16.pdf,2016,Karen E. Spilka,,"Senate, Senate Committee on Ways and Means","DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ETHICS RECEIVED COMMISSION ELECTED PUBLIC EMPLOYEE INFORMATION2016 DEC -9 PM 2:46 Name of elected public employee: Karen E. Spilka Title/ Position Massachusetts Senator Agency/ Department Senate, Senate Committee on Ways and Means Agency address: Room 212 State House Boston, MA 02133 Office phone: 617.722.1640 Office e-mail: Karen.Spilka@masenate.gov Write an X to confirm I am filing this disclosure because: each statement. _X_ I am going to engage in an activity that serves a legitimate public purpose, i.e., it is intended to promote the interests of the Commonwealth, a county or a municipality; and _X_ A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which is the reason for traveling. The Millbank Memorial Fund has arranged a two day symposium in Minneapolis on the subject of health care cost, quality and delivery. Presenters from the fields of government and public health will share lessons learned from Minnesota's efforts in the areas of health care payment and delivery system reform. Describe your participation in the activity. I will attend and participate in discussions regarding Minnesota's health care cost containment efforts and their applicability to similar efforts in the commonwealth. Date, time and location of activity. December 14 - 16, 2016 Commons Hotel 615 Washington Avenue SE Minneapolis, MN Please explain how the activity will promote the This trip will inform our work in the senate as we consider the next steps to take in interests of the health care cost containment policy. Minnesota is of particular interest to our work, Commonwealth, a county given its experience with controlling costs and improving care delivery in the areas of or a municipality. managed care, behavioral health, and long term services and supports. These same areas have substantial impact on health care costs in the commonwealth, and on the MassHealth program in particular. TRAVEL EXPENSES Identify the person or organization that offered to reimburse, Millbank Memorial Fund waive or pay your travel expenses. Address of person or organization. 645 Madison Ave., 15th Floor New York, NY 10022 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation: $615 (flight and ground transportation) Overnight accommodations. Lodging: $270 - 2 nights at the Commons Hotel Breakfast, lunch, dinner, special events. Meals: Registration, admission, tickets, etc. Admission: N/A Refreshment, instruction, materials, entertainment, etc. Other (please list): Total: Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county check off or a municipality; AND both statements. _X_ Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Karen E. Spilka Date: December 9 , 2016 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 State Massachusetts Research and Analysis of Policy Issues Related to Payment and Delivery System Reforms A Technical Assistance Meeting Sponsored by the Milbank Memorial Fund The Commons Hotel, Minneapolis, Minnesota December 15-16, 2016 AGENDA Thursday, December 15 9:00 A.M. Welcome and Introductions James Welch, Massachusetts Senate Trina A. Gonzalez, Program Officer, Milbank Memorial Fund 9:15 Medicaid Initiatives and Reforms: Minnesota and Massachusetts Lynn Blewett Director, State Health Data and Assistance Center and Professor, Health Policy and Management, University of Minnesota Dr. Blewett will provide an overview of Medicaid initiatives in Minnesota and Massachusetts. Dr. Blewett conducts research on the factors affecting health insurance coverage and access to and use of health care as these factors relate to state health policy. In addition to her roles with SHADAC and the University, Dr. Blewett directs the State Health Access Reform Evaluation, a Robert Wood Johnson Foundation national program that funds and evaluates health reform at the state level. 10:30 Community Paramedicine and Scope of Practice Issues in Minnesota: Lessons Learned Buck McAlpin Partner Libby Law Offices Community Paramedicine Background - context and political environment Program implementation, financing and oversight Scope of practice issues Background - context and political environment Specific issues targeted in Minnesota Buck McAlpin Mr. McAlpin has worked in the health care arena for over 20 years, starting as a 1"
032590f0f049597a1341df548330f8e1b616a4676dede003522e16078f339cf7,2014/SafranAlan.pdf,2014,Alan Safran,,,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. C. 268A, § 6 RECEIVED STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION Name: Alan Safran 2014 MAR 12 AM11:05 Title or Position: Director of Dissemination for Academic Support of Match Charter Public School (the ""Match School"") State Agency: Match Charter Public School Agency Address: 1001 Commonwealth Avenue Boston, MA 02215 Office Phone: (617) 232-0300 Office E-mail: asafran@matcheducation.org My duties to the Match School require me to participate in a particular matter in another entity, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other The Chief Executive Officer (the ""CEO"") of Match Charter Public School and Match Community Day proceeding, application, Charter Public School (collectively, the ""Schools"") has required that I provide services to The submission, request MATCH School Foundation, Inc. (the ""Foundation""), as part of my duties as the Director of for a ruling or other Dissemination for Academic Support of the Match School. determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: The CEO requires that I work with the Foundation, which serves as a dissemination arm of the Schools. The Foundation is a Massachusetts not-for-profit corporation, which is tax exempt under E.g., approval, Section 501(c)(3) of the Internal Revenue Code. As part of my official job responsibilities, I oversee disapproval, decision, the dissemination of tutoring model best practices learned from the School and the delivery of recommendation, academic content through the Foundation, which serves as a dissemination arm of the Schools. rendering advice, The Foundation is a Massachusetts not-for-profit corporation, which is tax exempt under Section investigation, other. 501(c)(3) of the Internal Revenue Code. As part of my official job responsibilities, I have been asked to lead the Foundation's engagement efforts with entities that are interested in adopting and deploying the Schools' tutoring model for public school students and to oversee the delivery of academic content from the Schools through these efforts. This work includes fielding requests made to the Foundation from those interested in the Schools' tutoring model, developing relationships between the Foundation and those entities, working with those entities to adopt the Schools' tutoring model, including recruiting and selecting tutors who will be employed by those entities which contract with the Foundation, managing the quality of these deployments, and the external relations associated with each deployment. In this capacity, I recruit, recommend for hire, support, supervise and evaluate the Foundation staff who engage in activities related to the work described in this paragraph. I will be compensated only by the Match School and will not be compensated by the Foundation for these activities, and I do not have an interest in contracts between the Schools and the Foundation. The CEO has required my services to the Foundation to assist with the dissemination of the Schools' education approach through the Foundation and to ensure that the Foundation provides effective support to the Schools. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter The Foundation, a Massachusetts not-for-profit corporation which is tax exempt under Section 501(c)(3) of the Internal Revenue Code, is the primary fundraising arm of the Schools. The Foundation is also a dissemination arm for the Schools, implementing the Schools' unique tutoring program in traditional public school settings and nationwide, and launching teacher training courses using the teacher training model in practice at the Schools. The Foundation also donates back office support to the Schools, leases space to the Match School, and has participated in certain financing arrangements to provide facilities for the Match School. The Foundation pays an administrative fee for services provided by the Schools to the Foundation (including those of the Schools' employees), but there is no contract between the Foundation and the Schools. Employee signature: alan PG Fafer Date: March "" , 2014 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Stig Leschly Authority: Title or Position: Chief Executive Officer Agency/Department: Match Charter Public School and Match Community Day Charter Public School Agency Address: 1001 Commonwealth Avenue Boston, MA 02215 Office Phone: (617) 232-0300 Office E-mail sleschly@matcheducation.org DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: By: As Lnee Stig Leschly, Chief Executive Officer of Match Charter Public School and Match Community Day Charter Public School Date: March H. , 2014"
032f504d05fcaeee9ba0232751be0ce9a0f88a02d4d475401378962428cfaf0c,2015/SohnIvy_1.pdf,2015,Ivy E. Sonn MD,,,"DISCLOSURE BY STATE EMPLOYEE OF A FINANCIAL INTEREST IN A CONTRACT TO PROVIDE SERVICES FOR THE COMMITTEE FOR PUBLIC COUNSEL SERVICES AS REQUIRED BY 930 CMR 6.06(2) STATE EMPLOYEE INFORMATION Name of state employee: Ivy E. Sonn MD Title/ Position Please provide information about your state employee position. Assistant Professor, university f inpissachusetts Medical School serving & child avez psychiamst for DMH contract undorsa Agency. University of Massachusetts Medical School Agency address: University of Massa chugtts Medical School Department of Psythiatry 55 North Lake Avenue worester. MA 01655 Office phone: (478) 863-5034 Office e-mail: ivy.sohn@mussmail.state.ma.us I am a state employee. The Committee for Public Counsel Services (""CPCS"") provides representation and services to persons with regard to various matters in the state courts and assigns attorneys and personnel to work on the matters. In connection with these matters, I expect to provide representation or services to, or on behalf of, such persons, attorneys or personnel. I respectfully request written approval of the arrangement from CPCS and (If 1 am not an elected state employee) from my appointing authority In my state position. CPCS SERVICES Describe the nature of the representation or Forensic psychalry evaluations. services you expect to provide to or for CPCS. If you are providing services through a company, please provide its name and address, Who will pay you for your services? CPCS, directly. An attorney or personnel assigned by CPCS. If not CPCS, please provide the name and address of the person or entity who will pay you or your company for your services. What is your financial Please explain your financial Interest and provide the dollar amount If you know it. interest In providing these services? I will be compansated for forensic psychiatic sences Please Include both rendcred on an hourly basis compensation and obligations, etc. Employee signature: APPROVAL BY COMMITTEE FOR PUBLIC COUNSEL SERVICES Name and title of CPCS employee giving approval LISA m Hawitt General Counsel Office phone 617-910-5717 Office e-mail LHAWITT 0 Poblic Counsel net Signature by By signing here, I indicate that have reviewed the facts that the state employee has disclosed CPCS employee above and approve the arrangement proposed by the state employee. Date: Jise h Healt 2-23-17 FOR NON-ELECTED STATE EMPLOYEES ONLY: APPROVAL BY APPOINTING AUTHORITY AT STATE AGENCY WHICH YOU SERVE Name and title of appointing authority, or Douglas M. Ziedonis, MD, MPH his or her designee, at the state agency which PROFESSOR and Chair you serve university umass of Massachusetts Medical School Dept. of Memorial PSYCHIATRY Medical Center and Office phone Office e-mail dulas.2iedon1s@LmAssMeMorial.oRg Signature by By signing here, I indicate that I have reviewed the facts that the state employee has disclosed appointing authority Date: above MiD418/15 and approve the arrangement proposed by the state employee. Attach additional pages If necessary. File copy with: State Ethice Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised March, 2013"
0334d9c78d08217bd812ea14e3708409c844bcc11403e1be85c021f6f0a57c69,"2020/Sansoucy,_George_E._1.15.20_-_6_-_4.pdf",2020,George E. Sansoucy,,,"The Commonwealth of Massachusetts RECEIVED Department of Revenue COMMISSION 2019 JAH 15 PM 2:58 Litigation Bureau 100 Cambridge Street KEVIN W. BROWN ACTING COMMISSIONER AND P.O. Box 9565 GENERAL COUNSEL Boston, MA 02114-9565 January 15, 2020 State Ethics Commission Room 619 One Ashburton Place Boston, MA 02108 Re: George E. Sansoucy, P.E.: Disclosure and Determination under G.L. c. 268A, § 6 To Whom It May Concern: Consistent with the requirements of G.L. C. 268A, § 6, I am filing herewith six separate Disclosures and Determinations with respect to an employee of the Department of Revenue, Mr. George E. Sansoucy, P.E, Massachusetts Certified General Appraiser. Mr. Sansoucy filed each such Disclosure of a financial interest in a particular matter with his appointing authority, Timothy Rooney, Chief Financial Officer, Department of Revenue. With respect to each of the six Disclosures, Mr. Rooney made the Determination that the financial interest was not so substantial as to be deemed likely to affect the integrity of the services that the Commonwealth may expect from Mr. Sansoucy. Thank you for your attention to this matter. Tax Counsel (617) 626-4002 DOCS # 482507/APO DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE EMPLOYEE INFORMATION Name: George E. Sansoucy Title or Position: Outside Expert Appraiser State Agency: Massachusetts Department of Revenue Agency Address: 100 Cambridge Street Boston, MA 02114 Office Phone: 603-788-4000 Office E-mail: gsansoucy@sansoucy.com My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter E.g., a judicial or other I work as an outside expert appraiser for the Department of Revenue for the proceeding, application, Commonwealth of Massachusetts (""DOR""). In that capacity, I make recommendations for submission, request for a ruling or other the valuation of telecommunication property that is subject to the provisions of the ""central determination, contract, valuation statute"" as set forth at G.L. C. 59, § 39. I additionally provide expert witness claim, controversy, services on behalf of the DOR concerning my recommended valuations. charge, accusation, arrest, decision, determination, or finding. My valuations affect every municipality in the Commonwealth of Massachusetts, including the City of Everett, MA. Your required participation in the Appraisal services through my company, George E. Sansoucy, P.E., LLC particular matter: E.g., approval, disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter My company's potential future employment is with the City of Everett, MA. The work will be to prepare updated appraisal reports of the personal property owned by Boston Gas, Mass Electric, NSTAR, and New England Power Company, to prepare an update of the real and personal property, and research and value any unreported and unvalued real property associated with the transmission and distribution systems in Everett as of January 1, 2020. (FY21). I believe this work will not negatively impact the central valuation telephone property work performed for Mass DOR. A similar disclosure was approved by the MASS DOR on 5/2/2019. Pursuant to G.L. C. 59, § 39, municipalities are required to use the DOR's central valuation of telecommunication property for local taxation purposes. Accordingly, municipalities in the Commonwealth, including the City of Everett, MA, often have an interest in the outcome of my work for the DOR. Employee signature: Date: 11-25-2019 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Timothy Rooney Title or Position: Deputy Commissionen and CFO, Financial Services Agency/Department: Massachusetts Department of Revenue Agency Address: 100 Cambridge Street Boston, MA 02114 Office Phone: 617-626-3515 Office E-mail DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Twith Rom Date: 1/15/20 Comment:"
0335e5822b2e6de4650df8184bf6ceadc08f0607ad61a203e342dde7ce782815,2015/ZimmererJesse.pdf,2015,Jessie Zimmerer,,"Office of Senator Sonia Chang-Diaz, Commonwealth of Massachusetts","DISCLOSURE BY NON-ELECTED PUBLIC EMPLOYEE OF INCIDENTAL HOSPITALITY AT AN EVENT SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(3)(b). PUBLIC EMPLOYEE INFORMATION Name of non-elected Jessie Zimmerer public employee: Title/ Position Legislative Director Agency/ Department Office of Senator Sonia Chang-Diaz, Commonwealth of Massachusetts Agency address: State House Room 111 Boston, MA 02133 Office phone: 617-722-1673 Office e-mail: Jessie.zimmerer@masenate.gov I am filing this disclosure because: Write an X My attendance at an event will serve a legitimate public purpose, i.e., it will promote the to confirm each interests of the Commonwealth, a county or a municipality; and statement. A non-public entity (but not a lobbyist) has offered to pay or waive expenses worth more than $50 related to the event. EVENT ATTENDED Describe the event that you will attend. Casa Myrna Sixth Annual Community of Conscience Breakfast: Celebrating Progress. The morning will educate attendees about domestic and dating violence, remarks by survivors and service providers will be delivered. Awards for service will be given. Describe your participation in the Attending on behalf of Senator Chang-Diaz in my role as Legislative Director and point event. person on issues involving public health (which domestic violence poses a threat to). I will be networking with providers and learning about their work. Additionally I will learn about the services currently provided to survivors and service gaps for survivors throughout the Commonwealth. Date, time and location Wednesday May 20, 2015 of event. 7:30-9:00AM Wyndham Boston Beacon Hill 5 Blossom Street Boston, MA 02144 Please explain how the activity will promote the Hearing directly from survivors and from service providers about the resources interests of the available and currently unavailable to survivors of domestic violence in regard to Commonwealth, a county housing, food supplements, education, medical services, legal assistance, and other or a municipality. supports is critical to ensuring that the laws in our Commonwealth serve/protect vulnerable communities. I am hoping to identify areas in which the Commonwealth can improve and to take note of those areas that are vital to maintaining services for survivors. It will also help me improve my ability to direct constituents to resources. EXPENSES RELATED TO INCIDENTAL HOSPITALITY Identify the person or Stephanie Brown, organization that Executive Director, offered to reimburse, Casa Myrna pay or waive expenses. Address of person or organization. P.O Box 180019 Boston, MA 02118 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire, etc. Transportation within the Commonwealth: Breakfast, lunch, dinner, special events. Meals: Admission: $75.00 Refreshment, entertainment, materials, etc. Other (please list): Total: $75.00 Employee signature: Date: SEE NEXT PAGE FOR DETERMINATION BY APPOINTING AUTHORITY DETERMINATION BY APPOINTING AUTHORITY APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Sonia Chang-Diaz Title/ Position: State Senator Agency/ Department Commonwealth of Massachusetts Agency Address: State House Room 111 Boston, MA 02133 Office Phone: 617-722-1673 Office E-mail: Sonia.chang-diaz@masenate.gov Employee who filed the disclosure: Jessie Zimmerer DETERMINATION Upon consideration of the facts disclosed by the employee above, I find that: To give approval, _X_______________________ The employee's attendance at the event will serve a legitimate public purpose i.e., it will check off promote the interests of the Commonwealth, a county or a municipality; AND both statements. _X__ Such public purpose outweighs any special non-work related benefit to the employee or the person paying or waiving expenses related to the event. Reason that the employee's travel or To learn about services and service gaps for domestic violence survivors in the attendance will serve a Commonwealth to inform her work on legislation, budget, and constituent services legitimate public matters. purpose: Appointing Authority signature: Smilm May 20, 2015 Date: Attach additional pages if necessary. The appointing authority should maintain the disclosure as a public record and give a copy of any signed determination to the employee. Form revised February, 2012"
033895ea6447162ceec3ee1afed008446bf275b94f8b3e98b78345efcdfc79f7,"2017/Sevigne,_Kym_Marie_8.3.17_-_CMR_6.02(3).pdf",2017,Kym Marie Sevigne,,,"The Commonwealth of Massachusetts Executive Office of Health and Human Servises Department of Mental Health COMMISSION 25 Staniford Street -3 AH11:31 Boston, Massachusetts 02114-2575 CHARLES D. BAKER Governor KARYN E. POLITO (617) 626-8000 Lieutenant Governor www.mass.gov/dmh MARYLOU SUDDERS Secretary JOAN MIKULA Commissioner July 11, 2017 Ms. Kym Marie Sevigne 429 Moore Street Ludlow, MA 01056 Dear Ms. Sevigne: I am pleased to appoint you for a three year term to the Holyoke/Chicopee Site Board with an expiration date of July 11, 2020. Your participation as a volunteer advisor to the Massachusetts Department of Mental Health is very much appreciated. The Department is committed to developing a service system that reflects local needs and meets high standards of care. Advances in care and treatment for individuals with mental illness, together with recognition of the need to partner with consumers to sustain their recovery in less restrictive environments have shifted the focus of treatment to the community. The Department's Community First vision is one that is aligned with consumer choice and the DMH public mental health system has transformed to empower consumers and families. Overwhelmingly, their choice to achieve their recovery is living independently - with the right supports - - in the community of their preference. Your active involvement as a Site Board member is critical to the success of the DMH mission and our Community First Initiative. I have enclosed a copy of the regulations governing citizen advisory boards. You will note that all board appointees must participate in training and orientation activities. Also note that you must be sworn in by two ""Commissioners to Qualify Public Officers"" within the next 90 days. Information regarding this requirement is attached and I suggest you confer with your Area Director as to the best way of meeting this requirement. Also, please be aware that, because you are an employee of an agency that currently contracts with the Department, you are required by the State ethics law, M.G.L. c.268A, to file a disclosure form with the State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108. A copy of the form is attached. Additionally, you should not participate as a Site Board member in any matter relating to or affecting your employer. On behalf of the Department, I would like to once again thank you for your participation as a Site Board member, and wish you much success in this important responsibility. Sincerely, Jan Joan Commissioner Mikula Mileale cc: Julie Schwager, Western Massachusetts Area Director Brad Cole, Holyoke/Chicopee Site Director DISCLOSURE OF ELECTION OR APPOINTMENT TO AN UNCOMPENSATED POSITION RECEIVED AS REQUIRED BY 930 CMR 6.02(3) TE ETHICS COMMISSION IDENTIFYING INFORMATION 2017 AUG -3 AM11:31 Name: Kym Marie Sevigne Your phone: 413-519-0050 (c) 413-536-8200 (w) Your e-mail: Kym.Sevigne@state.Ma.US STATE: I already have a job with a state agency or another direct or indirect financial interest in a contract made by a state agency, and I will begin serving in an uncompensated position with the same state agency or another state agency. Write an X COUNTY: I already have a job with a county agency or another direct or indirect beside one financial interest in a contract made by a county agency, and I will begin serving in statement. an uncompensated position with the same county agency or another agency of the same county. MUNICIPAL: I already have a job with a municipal agency or another direct or indirect financial interest in a contract made by a municipal agency, and I will begin serving in an uncompensated position with the same municipal agency or another agency of the same city or town. The uncompensated position will be: Check one. Elected or Non-elected FINANCIAL INTEREST I ALREADY HAVE IN A PUBLIC AGENCY CONTRACT Do you already have I HAVE THE CONTRACT. the contract with a public agency, or I work for a public agency for compensation. does another person or entity have the A contract that I have with a state public agency (e.g., a grant) funds my work; contract? I have a contract for goods, supplies or equipment, etc., with a public agency. Write an I have another type of contract with a public agency. beside the appropriate OR statement. ANOTHER PERSON OR ENTITY HAS THE CONTRACT. I work for a person or entity (e.g., a business, non-profit or organization), and my work is funded by a contract between the person or entity and a public agency. I have an ownership interest in a private entity (e.g, a business or non-profit), and the entity receives funds because of a contract with a public agency. I have an ownership interest in a private entity (e.g., a business or non-profit), and the entity has a contract for goods, supplies or equipment, etc. with a public agency. A public agency has a contract or transaction with a private person or entity, and I have a financial stake in the contract or transaction. CONTRACT BETWEEN A PUBLIC AGENCY AND YOU Fill out this part of the form if the public contract is with you. Name and address RECEIVED of the state, county Massachusetts Rehabilitation STATI Commission ETHICS or municipal agency that made the Holyoke Area office 2017 AUG -3 AM11:31 contract."
0348fc1d53ecdb3a16489039315ab325cccca8ef242e27b6826b41e6be21550b,"2016/Nguyen,_Pauline_section_6_disclosure_8.11.16.pdf",2016,Pauline Nguyen,,State Ethics Commission,"DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STAFF DISCLOSURE MAY BE C ONFIDENTIAL STATE EMPLOYEE INFORMATION Name: Pauline Nguyen DO NOT RELEASE THEM UNLESS EXECUTIVE DIRECTOR OR GENERAL Title or Position: Assistant General Counsel COUNSEL REVEIWS AND APPROVES RELEASE State Agency: State Ethics Commission Agency Address: One Ashburton Place, Rm 619 Office Phone: (617) 371-9500 Office E-mail: pauline.nguyen@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other proceeding, application, Hiring of new Executive Director submission, request for a ruling or other determination, contract, claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: As directed by Commission, tasks related to hiring of new Executive Director, including E.g., approval, but not limited to drafting position description and job posting, reviewing applications, disapproval, decision, recommendation, interviewing candidates, checking references, and making recommendations to rendering advice, investigation, other. Commission. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. __X_ I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter While my direct supervisor is the General Counsel, the Executive Director supervises the General Counsel and may have input into my performance reviews and decisions concerning my compensation. Employee signature: Paulinihgorhguyan Date: 8-11-2016 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Barbara Dortch-Okara Title or Position: Chair Agency/Department: State Ethics Commission Agency Address: One Ashburton Place, Room 619 Office Phone: (617) 371-9500 Office E-mail n/a DETERMINATION Determination by As appointing official, as required by G.L. C. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Sauh Date: 8/11/16 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108"
0355542a4de6439f4d687130148ee550eb4e55c3781ab8309f32ccc2ce4c1bf3,"2015/Chandler,_Harriette_930cmr5.082d2_disclosure_2015-10-01.pdf",2015,Harriette L. Chandler,,MA Senate,"RECEIVED STATE ETHICS COMMISSION DISCLOSURE BY ELECTED PUBLIC EMPLOYEE OF TRAVEL EXPENSES SERVING A LEGITIMATE PUBLIC PURPOSE AS REQUIRED BY 930 CMR 5.08(2)(d)2. ELECTED PUBLIC EMPLOYEE INFORMATION Name of elected public employee: Harriette L. Chandler Title/ Position MA Senate Majority leader Agency/ Department MA Senate Agency address: State House, Room 333 Boston, MA 02133 Office phone: (617) 722 -1544 Office e-mail: Write an X to confirm I am filing HarrieHe. Chandler@masenate.gov this disclosure because: each statement. I am going to engage in an activity that serves a legitimate public purpose, i.e., il is intended to promote the interests of the Commonwealth, a county or a municipality; and A non-public entity (but not a lobbyist) has offered to reimburse, waive or pay travel expenses and costs worth more than $50. ACTIVITY THAT SERVES A LEGITIMATE PUBLIC PURPOSE Describe the activity which Is the reason for Milbank Memonal Fund's Reforming States Group (RSG) traveling. met to discuss its goals for 2015, updates on prenous projects Describe your participation in the Participated as a member of the RSG activity. Steering Committee Date, time and location of activity. September 2-4 2015 in Denver, Co Please explain how the activity will promote the The Denver conference topics focused on health interests of the Commonwealth, a county Policy and the necessary resources and shills state or a municipality. health leaders need to meet health reform challenges State leaders learned that successful implementation of health reform depends on a combination 7 policy capacity and leadership. TRAVEL EXPENSES Identify the person or organization that Trina A. Gonzalez Program officer offered to reimburse, Milbank Memorial Fund waive or pay your travel expenses. Address of person or Milbank Memorial Fund organization. 645 Madison Arenue #15 New York, NY 10022 Provide information in as much detail as Itemization and explanation of amounts offered: possible: Air, train, bus, and taxi fare and rental car hire. etc. Transportation: $ 784 (airfare) Overnight accommodations. Lodging: $ 480 (hotel) Breakfast, lunch, dinner, special events. Meals: $ 286 Registration, admission, lickets, etc. Admission: N/A Refreshment, instruction, materials, enlertainment, elc Other (please list): N/A Total: $ 1,550 Write an X beside any I have attached the relevant itinerary. relevant statement. I have attached the relevant agenda. Having disclosed the facts above, I determine that: For the exemption Acceptance of the reimbursement, waiver or payment of travel expenses will serve a to apply, legitimate public purpose i.e., it will promote the interests of the Commonwealth, a county or a municipality; AND check off both statements. Such public purpose outweighs any special non-work related benefit to me or to the person providing the reimbursement, waiver or payment. Employee signature: Hamelle h. Chandler Date: 9/29/15 Attach additional pages if necessary. Elected state or county employees - file with the State Ethics Commission. Members of the General Court - file with the House or Senate clerk or the State Ethics Commission. Elected municipal employee - file with the City Clerk or Town Clerk. Elected regional school committee member - file with the clerk or secretary of the committee. Form revised February, 2012 The Reforming States Milbank Memorial Fund Group REFORMING STATES GROUP STEERING COMMITTEE MEETING Hotel Teatro Denver, Colorado September 2-4, 2015 AGENDA Wednesday, September 2 6:00 P.M. Reception - Wine Cellar 7:00 Dinner - Nickel Mezzanine Welcoming Remarks Harriette L. Chandler, Co-Chair, RSG Steering Committee Assistant Majority Leader Massachusetts Senate Christopher F. Koller, President, Milbank Memorial Fund (MMF) Individual Introductions Meeting participants 7:45 Welcome and Introduction of Guest Speakers Susan Birch, Vice Chair, RSG Steering Committee Executive Director Colorado Department of Health Care Policy and Financing Legalization of Marijuana: Lessons from Colorado On January 1, 2014, Colorado became the first state to legalize retail marijuana. Some predicted the state would see crime waves, an epidemic of addiction and overdose, and a tax windfall. More than a year later, other pressing issues have come to the forefront: what is the appropriate way to regulate the labeling of edible marijuana products? How can a state plan based on unpredictable tax revenues? What use are limits needed for public safety? As other states consider legalization, this panel will discuss the evolving marijuana policy landscape, the impact on the healthcare system and public health, and offer lessons learned. Andrew Freedman, Director Governor's Office of Marijuana Coordination Larry Wolk, Executive Director and Chief Medical Officer Colorado Department of Public Health and Environment G. Sam Wang, Assistant Professor of Pediatrics University of Colorado Medical Campus, Children's Hospital Colorado Thursday, September 3 7:00 A.M. Breakfast - Chancellor's Parlor 8:00 Welcome and Overview of Agenda Terry Cline, Co-Chair, RSG Steering Committee Secretary of Health and Human Services Oklahoma Department of Health 8:15 State and Jurisdiction Updates - 10 minutes for each report Meeting participants facilitated by co-chair. Each state will provide answers to the following questions: What has been the impact of the final state budgets on Medicaid and public health programs in your state? Will there be changes in the ACA landscape for your state in the near future? How has the State Innovation Model (SIM) grant played out in your state, if at all? 10:00 Break 10:15 Updates Continue 12:00 P.M. Lunch 1:00 MMF and RSG Program Activities Chris Koller Trina A. Gonzalez, Program Officer, Milbank Memorial Fund MMF Activities Update on MMF projects (Attachment #1) Discuss work on assessing impact (Attachment #2) RSG Activities"
036d7ddd4c33d8e60c4ace8713398e55498b57d0f43abb5941ef00d7ce8e9efd,2015/CampbellLIndaDean.pdf,2015,,,,"April 27, 2015 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Dear Commissioners: I write to disclose that I am an active state employee who receives or could receive health insurance through the Group Insurance Commission. Pending before the House of Representatives are two floor amendments relative to the FY'2016 budget: Amendment 403 has the effect of setting a 25% contribution rate for health insurance coverage for all active state employees. Amendment 903 has the effect of setting a 20% contribution rate for health insurance coverage for all active state employees. If adopted, changes to the contribution rates for state employees may have an effect on my personal financial interests which is different from the effect on the general public. I make this disclosure pursuant to G.L. c. 268A § 6A and consider it public in nature. Sincerely yours, State Representative C. Camp bell Linda Dean Campbell State Representative 15TH Essex"