disclosures: 01a0dc6fb7016720213dfa65320c3a769f1f36488110df250f1c4cba993e6cbf
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| 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, ยง 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 | 2018/Van_Der_Linden,_Vincent_9.17.18_-_7(b).pdf |