disclosures: 023bb40c51949883aa84445c2443dc4ab83b322179dfd60b1c5bf990bd07a673
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| 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 | 2013/Abbate-Vaughn.pdf |