HomeMy WebLinkAboutEric Miller 3/4/26 •
FILED
MAR 04 2026
UNIFORM CONFLICT OF SITEREST DISCLOSURE STATEMENT
Stair Fans 542066 1645)1 Ass zie
STATE BOARD OF Al:COM/TS •
CLERK LARK CI CUIT COURTS
Indiana Code 3544.1-14
• A public servant who knowingly or intentionally has a pecuniary Interest In cc derives a profit from
aptontract or purchase cormected vith an action by the governmental entity served by the public servant
oprrilts •wrW.of Interest,a Class D Felony. A public servant has a pecuniary kterest In a contract or
spirchase lf the contract or purchase we result or Is Intended to result in an ascertainable increase in the
.inCome or net worth of the public servant or a dependent of the pubic servant 'Dependent' means any
of the following: the spouse of a public senfant a chid,stepchild.or adoptee(as defined in IC 31-0-2-2)
die public servant who is unemancipated and less lhan eighteen (18)years of age; and any indivickzel
:more than one-half(1/2)of whose support is provided during a year by the public servant.
• The foregoing consists only of excerpts from IC 35-44.1-1-4. Care should be taken to review IC
. 3'5-44.1-14 in its entirety.
Mina and Address of Public Servant Submitting Statement 6lc-
//f
.0&44.1yefk. Fsif 47a.4
rt. „
2.a Title or Position With Governmental Erdity: Ke lot4eCti
3.' a. emserrimentei Entity: Cet 4Ar -Te-C4-13014/011-
•
Countl:
. This statement is submitted(disci(one):
•
• a. as a*single III:trisection disclosure statement.as to my financial Interest in a speeffIc contract or
• purchase connected with the governmentrd entity which I serve, proposed to be made by the
governmental entity with or from a particular contractor or vendor.or
•
• . as an'annual'disclosure statement.as to my financial Interest connected with any contracts or
purchases of the governmental entity with I serve,which are made on an ongoing basis with or
• f. from particular contractors or vendors.
•
Nams(s)of Contractor(s)or Veridoils): 0-4 •ce_c_-
..
.
_viazf('f:_a,z,,LA2tte,a
•
• .
Description(S) of Contract(s) or Purchase(*) (Describe the land of conbact Involved, and the
. •effedive date and barn of the contrad or purchase If reasonably datentUriable. Dates requked if af(e)
is selected above. If"dependent"is involvett provkie dependent's name and reladonshIp.):
4126)1,-)1
• .
•
•
•
. g. Page 1 of 3
4
•
7. Description of My Financial interest (Describe In what manner the pubfic servant or ffdepen-
: • denr opects to derive a profit or financial benefit from,or otherwise has a pecuniary kiterest in,
the above contract(s) or purchase(s); If reasonably determinable, state the apprcudrnate dollar
value of such profit or benefit):
• C L-X-r SATetiteic4 fA 0 e•At!ti
•'4 1A....27L—t- 14--11 yt41K--LP Par
•,,
. (Attach wdra pages additional space Is needed)
8., Approval of Appointing Officer or Body(To be completed if the public servant was appointed by
an elected pubic servant or the board of trustees of a stele-supported college or unimrsity.):
• '
I(We)being the ‘•Nr-Ot t)(- of
•
(Title of Officer or Narne of poverniry Body)
• CAA-ki %IC and having the power to appoint
- •
• (Name oGovenvnentel Eat)
the above named public servant to the pubic position to which he or she holds,hereby approve the
• '• participation to the appointed disclosing pubic servant in the above described contract(s) or
purchase(s)in which said pubic servant has a conflict of interest as defined in Indiana Code 35-
44.1-1-4; however,this approval does not waive any objection to any conflict prohibited by statute.
.• rule,or regulation and is not to be construed as a consent to any illegal act
•
Vi\44- V\C•1•(
I •
-Pr
079-4-
. bided Official Office
ctive Dates (Conflict of interest statements must be submkted to the governmental entity prior
to final action on hecontract or purrhase):
I--
• Dais Submitted(month day,yrad Date of Action on Contract or Purchase(mat"dr*pat)
•
. •
2•.
. •
•
, •
• •
•
- •
. • • •
Page 2 of3
:t •
•
▪ Affirmation of Public Servant: This disclosure was submitted to the governmental entity and
pccepted the
in a public meeting of the
to final
•
action on the contract or�purc purchase. I affirm,wider penaltyof perjury,the truth and entity
of
' the statements made above,and that t am the above named public serve
Signed:
• (Signalise of Pubk Servant)
•
• Date: 2frp/Lt -
(month,day,yew)
Printed Name: _ _fibik
se Pr e Q
(Plea" fegTb1y-)
email Addiess:eigcfbastjuud j (/i,.�I�.04•4-
j
Within fifteen (15)days after final action on the contract or purchase, copies of this statement must be
tied with the State Board of Accounts by uploading it here which is
the preferred method of filing,or by mailing it to the State Board of Accounts,Indiana Government Center
302 West Washington Street,Room E418,Indianapolis, Indiana,48204-2765 and the Clerk of the
irrxdt Court of the county where the governmental entity took final action on the contract or purchase.
•
•
•
•
• .
•
Page 3 of 3