HomeMy WebLinkAbout Zach Payne C I T Y O F J E F F E R S O N V I L L E
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u 812- 285 -6400 office
W 812- 285 -6403 fax
�1 J www.cityofjeff.net
AX F 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
1, ZACHARY PAYNE (printed name), the elected City Council 3rd District of " 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 Ordinance 2012 - OR-
29
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.
Dated this 2 day of�u d46-, , 20/3
(Signature) 4/.0 e
(Printed n ame
An equal opportunity employer.