{"database": "sfi", "table": "search_index_fts", "rows": [[41684, "2017/Chase,_Andrew_CMR_6.02(3)_1.26.17.pdf", "Fax Server 1/26/2017 2:04:03 PM PAGE 2/004 Fax Server RECEIVED STATE ETHICS COMMISSION DISCLOSURE OF ELECTION OR APPOINTMENT 2017 JAN 26 PM 2: 30 TO AN UNCOMPENSATED POSITION AS REQUIRED BY 930 CMR 6.02(3) IDENTIFYING INFORMATION Name: Andrew Chase Your phone: (508) 868 - 7142 (508) 868 7142 Your e-mail: andrestclace@gmail.com X STATE: I already have 3 job with a state agency or another direct or indirect financial interest in a contract made by a state agency, and : will begin serving if: an uncompansated position with the same state agency or another state agency. Write 33 X COUNTY } already have a job with 2 county agency or another direct or indirect heside 35555 financial Interest in 2 contract made by a county agency, and : will begin serving in statement. an uncompensated position with the same county agency or another agancy of the same county. MUNICIPAL : already have is job with a municipal agency or another direct or indirect financial interest in in contract made by = municipal agency, and : will begin serving in an uncompensated position with the same municipal egency os another agency of the same city or The uncompensated position will her Check can. Elected <<< Non-elected FINANCIAL INTEREST E ALREADY HAVE IN A PUSLIC AGENCY CONTRACT Do you stready have B HAVE THE CONTRACT. the contract with a public agency, or : work for a public agency tor compensation does another person or entity have the A contract that I have with 8 state public agency (e.g., a grant) funds my work; contract? : have 3 contract for goods, supplies or equipment. etc., with & public agency. Write an % : have enother type of contract with 3 public agency beside the appropriate OR statement. ANOTHER PERSON OR ENTITY HAS THE CONTRACT. : work for a person or entity (e.g., 3 business, non-profit or organization), and my work is funded by a contract behween the person or entity and 3 public agency. i have an ownership interest in 2 private entity (6.0. a business or non-profit), and the entity receives funds because of a contract with a public agency. } have an ownership interest in ; private entity (e.g. B business or non-profit), and 38 entity has 3 contract for goods, supplies IV equipment. etc. with a public agency. A public agency HAS a contract or transaction with as private person or entity, and : have a financial stake in the contract or transaction. Fax Server 1/26/2017 2:04:03 PM PAGE 3/004 Fax Server CONTRACT BETWEEN R PUBLIC AGENCY AND you Fill out this Dect of the form if the public contract is with you Name and address of the state. county or municipal agency that made the contract. What is the contract E.g. 10 it a contract tor your services is tor goods, supplies or equipment 0: something Meal for? What 3 your Please include's dollar amount if possible financial interest in the public agency contract? Please include both financial advantages and obligations CONTRACT BETWEEN in PUBLIC AGENCY AND ANOTHER PERSON OR ENTITY Fill out this part of the form if the contract is with another person or 80 entity Name and address of the state. county EUHAS or municipal agency that made the $00 WASHINGTON * contract Boshn wA Please provide the name and address VMUS Medical shot of the person or $14 Mam sk: entity that has the contract. chinlestown MA What relationship do E.g., are you en owner, partner or employee of & company that signed the contract? or of is you have with the subsentractor to such c company? person or antity that has the public employee contract? What its the contract Eg. :- it A contract AX services or for goods, supplies equipment D: something also? 807 IsA in Services relative 30 timed my healthy - Monthect What is your Please explain !!! Insural interest and include & delier amount if you know 4. financial interest in the public agency con player in the Exite licensery Dust at Dears school contract? Please include best $57,691.08/4 Salary financial advantages and obligations. Fax Server 1/26/2017 2:04:03 PM PAGE 4/004 Fax Server UNCOMPENSATED PUBLIC POSITION Name and address of the public agency The CASA Project where you will have en uncompensated 100 Grove St., 4th Floor position. Worceater, MA 010.5 What is the uncompenseted position? Guardian Ad Likem, Wouster Irvenils Cant Who elected or appointed you to the desition? N/A. Employee signature. alhose Date: 1/24/2016 Attach additional cages if necessary. $ you already had 3 compensated public position. file this disclosure with your appointing authority for that position. OTHERWISE, IF you 3555 reporting ** uncompensated position with the siste or 3 county, file this disclosure with the State Ethics Commission. If you are reporting 30 uncompensated position with a city or town, file this disclosure with # city Dr town clarx. Form revised February, 2012"]], "columns": ["rowid", "title", "search_1"], "primary_keys": ["rowid"], "primary_key_values": ["41684"], "units": {}, "query_ms": 1.0305345058441162, "source": "State Ethics Commission", "source_url": "https://www.mass.gov/file-or-view-statements-of-financial-interests-sfi", "license": "ODbL", "license_url": "https://opendatacommons.org/licenses/odbl/"}