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Home My WebLink AboutAmy Semones CITY OF JEFFERSONVILLE GAT Y Off. ~ iiii o 812-285-6400 office % N 812-285-6403 fax J U www.cityofjeff.net %?SOA44‘ Jeffersonville City Hall 500 Quartermaster Court Jeffersonville,Indiana 47130 CERTIFICATION OF ELECTED OFFICIAL TO THE EXECUTIVE OF THE "CITY OF JEFFERSONVILLE ON COMPLIANCE WITH MUNICIPAL NEPOTISM POLICY I, Amy Semones, the elected COMMON COUNCIL DISTRICT 3 "City of Jeffersonville" certify that I have not violated the "City of Jeffersonville" Contracting with a Unit Policy of IC 36-1-21, as amended or supplemented, relating to contracts of my relatives' business interests with the" City of Jeffersonville" as further described in 2012-OR-29 document adopting AN ORDINANCE ADOPTING CONFLICT OF INTERESTAND NEPOTISM LAW POLICY. I understand that Relative means my spouse, parent or stepparent, child or stepchild, brother, sister, stepbrother, stepsister, niece, nephew, aunt, uncle, daughter-in-law or son-in- law (including half-bloods and adopted children). I intend for this to be submitted to the Mayor prior to the end of this calendar year. I hereby verifyyder the penalty of perjury that the foregoing statements are true. Dated this() day of OA tAa , 200 1/ 40114i ALVA (Signature) allb - rn ernMes (Printed n.me) CITY OF JEFFERSONVILLE GAT Yrr OA,. ok = 0 812-285-6400 office W Itk' fr N 812-285-6403 fax �� ea www.cityofjeff.net %\FRSl Jeffersonville City Hall 500 Quartermaster Court Jeffersonville,Indiana 47130 ANNUAL CERTIFICATION OF ELECTED OFFICIAL TO THE EXECUTIVE OF THE CITY OF JEFFERSONVILLE ON COMPLIANCE WITH MUNICIPAL NEPOTISM POLICY INVOLVING DIRECT LINE SUPERVISION I, Amy Semones,the elected COMMON COUNCIL DISTRICT 3 ,of Jeffersonville certify that I have not violated the City of Jeffersonville Nepotism Policy in hiring and supervision of IC 36-1-20.2, as amended or supplemented, relating to my relatives' employment with the City of Jeffersonville as further described in 2012-OR-29 document adopting AN ORDINANCE ADOPTING CONFLICT OF INTERESTAND NEPOTISM LAW POLICY. I understand that Relative means my spouse, parent or stepparent, child or stepchild, brother, sister, stepbrother, stepsister, niece, nephew, aunt, uncle, daughter-in-law or son-in-law (including half-bloods and adopted children). I intend for this to be submitted to the Mayor prior to the end of this calendar year. I hereby verify under the penalty of perjury that the foregoing statements are true. 01 Dated thi• o :ay of , 20,4 41111PA. Jr AMID (signature(-9.7A/ti )' ' IPACNS (printed r e)