search_index: sfi.db/disclosures, 9e3332b84cd3d8e3d34030453adb3a6c505ab0c0c6dae85fd3c90add28ecd8e2
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| sfi.db/disclosures | 9e3332b84cd3d8e3d34030453adb3a6c505ab0c0c6dae85fd3c90add28ecd8e2 | 2024/McDermott_MiKaela_8.28.24_7(d).pdf | 2024-01-01T00:00:00 | 1 | RECEIVED STATE ETHICS COMMISSION 398 West Clinton Street 2024 AUG 28 AM 10: 58 New Bedford, MA 02740 August 26, 2024 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 To Whom It May Concern: Enclose please find a Disclosure by Special State Employee of Financial Interest in a State Contract as Required by G.L. c. 268A, § 7(d). Sincerely, A. Mikaela A. McDermott 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 Mikaela A. McDermott 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 Hearing Officer, Commonwealth Health Insurance Connector Authority 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: Commonwealth Health Insurance Connector Authority Agency Address: 100 City Hall Plaza Boston, MA 02108 Office phone: 617-933-3057 (Note: this is the general phone number for the Health Connector. I work remotely and do not have a phone line there). Office e-mail: mikaela.a.mcdermott@mass.gov. Check one: Elected or Non-elected Starting date as a 8/31/22 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). 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." Cannabis Control Commission Name and address 2 Washington Square, Union Station, 2nd Floor of state agency that Worcester, MA 01604 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 I will serve as a part-time, contracted hearing officer for the Cannabis Control Commission. |