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Attachment 1 - Disclosure Form.pdf

Rialto City Council
October 24, 2023

Document
Attachment 1 - Disclosure Form.pdf
Meeting
October 24, 2023
Body
Rialto City Council
Original file
350 KB
Text extracted from the city's file for reading and search. Open the original on legistar.granicus.com. That file is the official record.

CITY OF RIALTO

DISCLOSURES REQUIRED BY PERSONS OR ENTITIES
CONTRACTING WITH THE CITY OF RIALTO*
Pursuant to City of Rialto Municipal Code Section 2.48.510, all persons or business entities supplying any goods or services to the city, or seeking a loan or grant awarded by the city, whether through an application or proposal, shall disclose in such application or proposal whether any city officer, employee, or consultant may have a financial or non-financial interest in the person or business entity, or in any member, employee, owner, or officer of the business entity.
• A financial interest shall mean any interest that is prohibited under state law, including California Government Code Sections 1090 and 87100, and California Code of Regulation Section 18700 et seq. • A non-financial interest shall mean any interest that is prohibited by City of Rialto Municipal Code Section

2.48.450.

To assist the City in determining whether your item presents a conflict of interest under California Law or the Rialto Municipal Code please fully complete the table below. For any category that is not-applicable please print "N/A" in each box. A conflict may arise if you, or any person in your organization (like an employee, or board member), box. Please use additional sheets if necessary.

Relationship Between the
Name of Your Organization's Name of City Elected or Two Affected Member, Employee, Appointed Official, City
Paid or Unpaid Officer, Paid or Officer, a City Employee or Unpaid Director, or Owner Consultant
Vernon Perry Angela Perry Spouse.

By submitting the corresponding application, bid, or proposal by which a contract may be entered into with the City for supplying any goods or services to the City, or for constructing any public works project, the person or entity identified below hereby attests under penalty of perjury, personally and/or on behalf of the entity, that no City of Rialto elected or appointed official, employee or consultant has a financial or non-financial interest, as such terms are defined in California Government Code Sections 1090 and 87100 and in City of Rialto Code of Ordinances Section 2.48.450, with the person or entity identified below, except as specifically disclosed herein.

Name of Person/Entity: Soheil Sadighi
Title: General Manager
Signature: Date: 12/8/22
Form Date 9/1/2022

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