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39434	2013/gemmeIrene9.30.13.pdf	WORK OPPORTUNITY CENTER INC. 1094 Suffield Street, P.O. Box 481, Agawam, MA 01001 Tel(413) 786-8830 Fax (413) 789-6771 STATE ETHICS COMMISSION 2013 SEP 30 AM 10: 14 September 24, 2013 State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 To Whom it May Concern, I am submitting two (2) Disclosers of Appearance of Conflict of Interest forms on behalf of Work Opportunity Center, Inc. Please feel free to contact me with any questions. I may be reached at (413) 786-8830 x24. Thank you. Sincerely, SL Michaelian Sandra L. Michaelian Asst Mgr of Employment Supports for the Production Facility & Enclaves DISCLOSURE OF APPEARANCE OF CONFLICT OF INTEREST AS REQUIRED BY G. L.C.268A §23(b)(3) RECEIVED I make this disclosure pursuant to G.L.c.268 A, §23 (b)(3) in order to dispel any appearance of potential conflict of interest occasioned by the facts set out below, that I may be improperly or unduly influenced in the performance of my official duties, or that 1 would be likely to act or fail to act as a result of kinship, rank, position pr the undue influence of any part or person. Name: Icene Gemme Title or Position: Agency/Department: Work Opportunity Center, Inc Agency address: 1094 Suffield st agawam, ma 01001 Office Phone: 413-7816 - 8830 I publicly disclose the following facts I, Irene Gemme, am a member (Attach additional of the Human Rights Committee pages if necessary): at Work Opportunity Center, Inc and my son attends the woc, Inc program my husband, Lionel Gemme, serves on the Board of Directors and our son attends the woc, Inc program Suppartive EMPLOYMENT PROGRAM Signature: Greae H Menrice G.L.c.268 X A, §23 (b)(3): No current officer or employee of a state, county or municipal agency shall knowingly, or Date: 9-20-13 with reason to know, act in a manner which would cause a reasonable person, having knowledge of the relevant circumstances, to conclude that any person can improperly influence or unduly enjoy his favor in the performance of his official duties, or that he is likely to act or fail to act as a result of kinship, rank, position or undue influence of any party or person. It shall be unreasonable to so conclude if such officer or employee has disclosed in writing to his appointing authority or, if no appointing authority exists, discloses in a manner which is public in nature, the facts which would otherwise lead to such a conclusion. Appointed state, county and municipal officials and employees should file with their appointing authority. Elected state officials should file with the appropriate House or Senate Clerk or the Ethics Commission. Elected county officials should file with the county clerk. Elected municipal officials should file with the city or town clerk. Attach additional pages if necessary.