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HomeMy WebLinkAbout2017_0421_BOE_Packet_OpenMary Tudela Chair Michael Curtis Vice -Chair Maureen Tabura Secretary Members: Susan Burriss Ryan de la Pena Calvin Murashige Mia Shiraishi RECEIVED COUNTY OF KAUA'I BOARD OF ETHICS �� A �� -Al NOTICE OF MEETING AND AGENDA Friday, April 21, 2017 1:00 p.m. or shortly thereafter Mo`ikeha Building, Liquor Conference Room 3 4444 Rice Street, L-ihu'e, HI 96766 Oath of Office for Susan Howie Burriss (new appointee) CALL TO ORDER APPROVAL OF MINUTES OFFICE OF THE COUNTY CLERK COUNTY OF KALIA' i Open Session Minutes of March 17, 2017 COMMUNICATION BOE 2017-05 Copy of a memorandum dated March 21, 2017 from Arryl Kaneshiro, Councilmember to Council Chair Mel Rapozo and Members of the Kauai County Council regarding his recusal for a possible conflict of interest relating to Bill No. 2645, the Mayor's Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriations for the East Kauai Soil & Water Conservation district. BOE 2017-06 Copy of a memorandum dated March 21, 2017 from Arryl Kaneshiro, Councilmember to Council Chair Mel Rapozo and Members of the Kauai County Council regarding his recusal for a possible conflict of interest relating to Bill No. 2645, the Mayor's Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriations for Grove Farm Company, Inc. BOE 2017-07 Copy of a memorandum dated March 17, 2017 from JoAnn A. Yukimura, Councilmember to Council Chair Mel Rapozo and Members of the Kauai County Council regarding her recusal for a possible conflict of interest relating to Bill No. 2645, the Mayor's An Equal Opportunity Employer Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriations for the Boys & Girls Club. REQUEST FOR AN ADVISORY OPINION RAO 17-006 Letter dated March 2, 2017 from Chief of Police Darryl D. Perry requesting to review copy of a letter and application dated February 9, 2017 from Ms. Vykky Gamble, EAH Housing Property Supervisor seeking applicants for the Resident Police Officer Program at Kaniko'o II and determine if it violates the County of Kauai Code of Ethics. RAO 17-007 Verbal request from Administrator Jay Furfaro of The Office of Boards and Commissions requesting guidance in clarifying the Kauai County Board of Ethics Disclosure Statement requirements as it pertains to disclosing income from stock sales and real property. DISCLOSURES 1. Michael Martinez (Fire Commission) 2. Heather Kanoe Ahuna (Planning Commission) 3. Susan Howie Burriss (Board of Ethics) 4. Craig Anthony De Costa (Board of Review) 5. Wade Larry Lord (Planning Commission) 6. Russell Mark Kapi`olani Wong (Board of Review) ANNOUNCEMENTS Next Meeting: Friday, May 19, 2017 — 1:00 p.m., Mo`ikeha Building, Liquor Conference Room ADJOURNMENT NOTICE OF EXECUTIVE SESSION Pursuant to Hawaii Revised Statutes §92-7 (a), the Board may, when deemed necessary, hold an executive session on any agenda item without written public notice if the executive session was not anticipated in advance. Any such executive session shall be held pursuant to HRS §92-4 and shall be limited to those items described in HRS §92-5(a). c: Nicholas Courson, Deputy County Attorney 21Pa`e Board of Ethics — April 21, 2017 PUBLIC COMMENTS and TESTIMONY Persons wishing to offer comments are encouraged to submit written testimony at least 24-hours prior to the meeting indicating: 1. Your name and if applicable, your position/title and organization you are representing; 2. The agenda item that you are providing comments on; and 3. Whether you will be testifying in person or submitting written comments only. 4. If you are unable to submit your testimony at least 24 hours prior to the meeting, please provide 10 copies of your written testimony at the meeting clearly indicating the name of the testifier; and While every effort will be made to copy, organize and collate all testimony received, materials received on the day of the meeting or improperly identified may be distributed to the members after the meeting is concluded. The length of time allocated to persons wishing to present verbal testimony may be limited at the discretion of the chairperson or presiding member. Send written testimony to: Board of Ethics Attn: Sandra Muragin Office of Boards & Commissions 4444 Rice Street, Suite 150 Lihu`e, HI 96766 Email: smuragin@kauai.gov Fax: 241-5127 Phone: 241-4919 SPECIAL ASSISTANCE If you need an alternate format or an auxiliary aid to participate, please contact the Boards & Commissions Support Clerk at 241-4919 at least five (5) working days prior to the meeting. 31Pa��e Board of Ethics — April 21, 2017 COUNTY OF KAUAI -J Minutes of Meeting OPEN SESSION Board/Committee: BOARD OF ETHICS Meeting Date March 17, 2017 Location Mo`ikeha Building, Liquor Conference Room 3 Start of Meeting: 1:00 p.m. End of Meeting: 1:16 p.m. Present Chair Mary Tudela; Vice Chair Michael Curtis; Secretary Maureen Tabura. Members: Ryan de la Pena; Calvin Murashige; Brad Nagano, Mia Shiraishi Staff. Deputy County Attorney Bentley Adams; Boards & Commissions Office: Commission Support Clerk Sandra Muragin Excused Boards & Commissions Office Administrator Jay Furfaro Absent SUBJECT DISCUSSION ACTION Call To Order Chair Tudela called the meeting to order at 1:00 p.m. with 7 members present. Approval of Minutes Regular Open Session Minutes of February 17, 2017 Mr. Nagano moved to approve the Open Session Minutes of February 17, 2017. Mr. Murashige seconded the motion. Motion carried with 7:0 Communication BOE 2017-03 Letter dated February 7, 2017 from Thomas Canute, Board of Mr. Curtis motioned to amend the agenda and move BOE 2017-03 from Communications to Request for an Advisory Opinion. Ms. Tabura seconded the motion. Motion Carried 7:0 Water Supplregarding_potential conflict of interest as current appointed Board Member and Treasurer for the Kauai Habitat for Humanity (KHFH) that is building affordable housing on Kauai. The Board of Water is proposing a reduction in the current Facilities Reserve Charge (FRC) for those individuals or entities building and/or developing affordable housing benefit directly from the lower on Kauai. The KHFHon The KHFH organization would benefit directly the lower FRC charge. Chair Tudela informed the Board that an amendment to the agenda was required. The first communication item, BOE 2017-03 is technically a request for an advisory opinion. She asked the Board for a motion to amend the agenda and move BOE 2017-03 from Communications to Request for an Advisory Opinion. Board of Ethics Open Session March 17, 2017 Page 2 SUBJECT DISCUSSION ACTION BOE 2017-04 Copy of a memo dated February 17, 2017 from Agyl Kaneshiro, Council member to Council Chair Mel Rapozo regarding his recusal for a possible conflict of interest relating to agenda items C 201718, a dedication deed (Lot 1-A-5-A) from Grove Farm Company, Incorporated, Ms. Tabura moved to accept communication to the County of Kauai. Mr. Kaneshiro is a Project Manager for Grove BOE 2017-04. Mr. Nagano seconded the Farm Com an Inc. motion. Motion carried 7:0 Request for an RAO 17-004 Letter dated February 27, 2017 from Sherman Shiraishi, Advisory Attorney, regarding association with Kauai Habitat for Humanity (KHH) conflict of interest in considering the Department of Water rule changes that Opinion would impact fees for affordable housing units. Chair Tudela acknowledged Attorney Sherman Shiraishi and asked if there was anything in addition that he wanted to share with the Board members. Mr. Shiraishi stated he did not but was available for any questions from the Board. Ms. Shiraishi recused herself from the discussion and remained in the room. Mr. Curtis moved to receive RAO 17-004 and Mr. Murashige stated he did not see a need to recuse himself but informed that there is no conflict of interest. Mr. de la the Board that he was a business partner with Mr. Shiraishi that ended back Pena seconded the motion. in 1999. Motion carried 6:1 (recusal: Shiraishi) Chair Tudela thanked Mr. Shiraishi for his time. BOE 2017-03 Letter dated February 7, 2017 from Thomas Canute, Board of Water Supply regarding potential conflict of interest as current appointed Board Member and Treasurer for the Kauai Habitat for Humanity (KHFH) that is building affordable housing on Kauai. The Board of Water is proposing a reduction in the current Facilities Reserve Charge (FRC) for those individuals or entities building and/or developing affordable housing Board of Ethics Open Session March 17, 2017 Page 3 SUBJECT DISCUSSION ACTION on Kauai. The KHFH organization would benefit directly from the lower FRC charge. Mr. Murashige inquired if Mr. Canute was notified that his presence at the meeting might assist the Board in determining receipt of his letter? Chair Tudela asked Commission Support Clerk Muragin if Mr. Canute was notified. Ms. Muragin answered not that she was aware of. Based on that response Chair Tudela suggested to defer and give Mr. Canute an opportunity to present himself. She then asked for advice from Deputy County Attorney Bentley Adams. Mr. Adams suggested the Board defer for process reason. Chair Tudela addressed the Board that Mr. Adams suggested a deferral for processing reasons and to allow Mr. Canute the opportunity to present himself. Mr. Curtis stated he didn't think a deferral was necessary. Mr. Curtis motioned to receive Mr. Canute's disclosure and find that there is no conflict of Mr. Curtis said it's similar to Mr. Shiraishi's disclosure. Mr. Canute interest. Mr. de la Pena seconded the motion. disclosed his position and he did not see any conflict of interest and that is why he made the motion to receive. Mr. Curtis stated that his presence would not alter the Board's decision. Mr. Murashige shared that he saw a slight difference from Mr. Shiraishi's requests. He noted Mr. Shiraishi's involvement with Kauai Habitat For Humanities (KHFH) would constitute as incidental. He stated it's not on a regular basis, it could be but it's not, Mr. Shiraishi is not a non-profit attorney. The issue with Mr. Canute's situation is that he is a Board member. Mr. Murashige questioned the impact a board member would Board of Ethics Open Session March 17, 2017 Page 4 SUBJECT DISCUSSION ACTION have. He brought up a past situation that the Board reviewed regarding Mr. Kukai Kuali'i. There was concern because of his involvement with the YWCA (Young Women's Christian Association). Chair Tudela acknowledged consistency with prior decisions as a way to decide on potential conflicts. For comparison she remembered there was one about the government, taxation or increases in prices that was going to affect everyone. She believed the Board supported it and found it did not have an issue. Chair Tudela said that Mr. Canute's disclosure is in the same category because a vote would imply all non -profits not just the KHFH. She stated that is why she is leaning more towards Mr. Curtis direction, because any decision made would be for all non -profits not just specific to KHFH. Mr. Nagano said he remembered the Kuali'i discussion. He said that Mr. Kuali'i was a Board member and that it specifically funded the YWCA. Chair Tudela agreed. Ms. Shiraishi shared that a Board member has a certain duty to act in the best interest of the organization serving. She felt he would have to vote for the FRC (Facilities Reserve Charge) a certain way in order to support the organization. Mr. Curtis inquired about the differences for the Board of Water Supply FRC between non -profits, home owners and new building permits. Mr. Murashige stated it could be for individuals. Mr. de la Pena confirmed it could be for individuals and entities building affordable housing. Motion carried 5:2 (nay: Murashige and Chair Tudela called for the question. Shiraishi) Board of Ethics Open Session March 17, 2017 Page 5 SUBJECT DISCUSSION ACTION Disclosures 1. Kimberly Asako Toriog e (Deputy Prosecuting Attorney) Ms. Tabura moved to receive Disclosures 1, 2, 3, 2. BentleyChilds Adams III (Deputy County Attorney) 4 and deem them complete with Disclosure 5 3. Ginger Davis Grinpas (Deputy Prosecuting Attorney) being incomplete for a blank area. Mr. de la 4. Alfred C. Garces Jr. (Fire Commission) Pena seconded the motion. Motion carried 7:0 5. Michael Martinez (Fire Commission) Announcements Next Meeting: Friday, April 21, 2017 — 1:00 p.m., Mo'ikeha Building, Li uor Conference Room Adjournment Mr. Murashige moved to adjourn the meeting at 1:16 p.m. Ms. Tabura seconded the motion. Motion carried 7:0. Submitted by: Sandra M. Muragin, Commission Support Clerk () Approved as circulated. () Approved with amendments. See minutes of meeting. Reviewed and Approved by: Mary Tudela, Chair COUNTY COUNCIL Mel Rapozo, Chair Ross Kagawa, Vice Chair Arthur Brun Mason K. Chock Arryl Kaneshiro Derek S.K. Kawakami JoAnn A. Yukimura TO: FROM: RE: Council Services Division 4396 Rice Street, Suite 209 Lihu`e, Kauai, Hawaii 96766 MEMORANDUM March 21, 2017 Mel Rapozo, Council Chair and Members of the Kauai County Council Arryl Kaneshiro, Councilmember AK OFFICE OF THE COUNTY CLERK Jade K. Fountain-Tanigawa, County Clerk Scott K. Sato, Deputy County Clerk Telephone: (808) 241-4188 Facsimile: (808) 241-6349 E-mail: cokcouncil@kauai.gov •JL�li L MAR 2 4 2017 !. 1 B04RD3 & COMM 1SS101,'S POSSIBLE CONFLICT OF INTEREST RELATING TO BILL NO. 2645, THE MAYOR'S PROPOSED OPERATING BUDGET FOR FISCAL YEAR 2017-2018 — APPROPRIATIONS FOR THE EAST KAUA`I SOIL & WATER CONSERVATION DISTRICT Pursuant to Section 20.04(B) of the Kauai County Charter, Section 3-1.9 of the Kauai County Code 1987, as amended, and Rule No. 8 of the Rules of the Council of the County of Kauai, I hereby provide written disclosure on the record of a possible conflict of interest relating to Bill No. 2645, the Mayor's Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriation to Kauai Soil Conservation in the Department of Public Works — Grant -In -Aid, as I am a Director for the East Kauai Soil & Water Conservation District. In light of the above, I will recuse myself from the aforementioned item during the Fiscal Year 2017-2018 Departmental Budget Reviews, Budget Call -Backs, and Decision -Making, related to this item, and any subsequent meeting thereafter related to this item. Should you have any questions, please feel free to contact me. Thank you for your attention to this matter. JA:cy cc: April 12, 2017 Council Meeting Agenda County of Kauai Board of Ethics Council Services Staff Fiscal Year 2017-2018 Budget File AN EQUAL OPPORTUNITY EMPLOYER boo d2O 110 a 6 COUNTY COUNCIL Mel Rapozo, Chair Ross Kagawa, Vice Chair Arthur Bran Mason K. Chock Arryl Kaneshiro Derek S.K. Kawakami JoAnn A. Yukimura Council Services Division 4396 Rice Street, Suite 209 Lihu`e, Kauai, Hawaii 96766 MEMORANDUM March 21, 2017 TO: Mel Rapozo, Council Chair and Members of the Kauai County Council FROM: Arryl Kaneshiro, Councilmember Al" - OFFICE OF THE COUNTY CLERK Jade K. Fountain-Tanigawa, County Clerk Scott K. Sato, Deputy County Clerk Telephone: (808) 241-4188 Facsimile: (808) 241-6349 E-mail: cokcouncil@kauai.gov !� I! MAR 2 4 j EOARODS & COMMISSII:�!S I_ RE: POSSIBLE CONFLICT OF INTEREST RELATING TO BILL NO. 2645, THE MAYOR'S PROPOSED OPERATING BUDGET FOR FISCAL YEAR 2017-2018 — APPROPRIATIONS FOR GROVE FARM COMPANY, INC. Pursuant to Section 20.04(B) of the Kauai County Charter, Section 3-1.9 of the Kauai County Code 1987, as amended, and Rule No. 8 of the Rules of the Council of the County of Kauai, I hereby provide written disclosure on the record of a possible conflict of interest relating to Bill No. 2645, the Mayor's Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriation to Grove Farm (Puhi Metals Recycling) Liabilities in the Department of Finance — Administration and 800 MHz Radio Site Lease: Grove Farm appropriation in the Emergency Management Agency, as I am a Project Manager employed by Grove Farm Company, Inc. In light of the above, I will recuse myself from the aforementioned item during the Fiscal Year 2017-2018 Departmental Budget Reviews, Budget Call -Backs, and Decision -Making, related to this item, and any subsequent meeting thereafter related to this item. Should you have any questions, please feel free to contact me. Thank you for your attention to this matter. JA:aa cc: April 12, 2017 Council Meeting Agenda County of Kauai Board of Ethics Council Services Staff Fiscal Year 2017-2018 Budget File AN EQUAL OPPORTUNITY EMPLOYER F 4AO'1' 0 COUNTY COUNCIL Mel Rapozo, Chair Ross Kagawa, Vice Chair Arthur Brun Mason K. Chock Arryl Kaneshiro Derek S.K. Kawakami JoAnn A. Yukimura Council Services Division 4396 Rice Street, Suite 209 Lihu`e, Kauai, Hawai'i 96766 MEMORANDUM March 17, 2017 TO: Mel Rapozo, Council Chair and Members of the Kauai County Council FROM: JoAnn A. Yukimura, Councilmember OFFICE OF THE COUNTY CLERK Jade K. Fountain-Tanigawa, County Clerk Scott K. Sato, Deputy County Clerk Telephone: (808) 241-4188 Facsimile: (808) 241-6349 E-mail: cokcouncil@kauai.gov If ( f MAR 242017 BOAC'C'S & COMMISSIONS RE: POSSIBLE CONFLICT OF INTEREST RELATING TO BILL NO. 2645, THE MAYOR'S PROPOSED OPERATING BUDGET FOR FISCAL YEAR 2017-2018 — APPROPRIATIONS FOR THE BOYS & GIRLS CLUB Pursuant to Section 20.04(B) of the Kauai County Charter, Section 3-1.9 of the Kauai County Code 1987, as amended, and Rule No. 8 of the Rules of the Council of the County of Kauai, I hereby provide written disclosure on the record of a possible conflict of interest relating to Bill No. 2645, the Mayor's Proposed Operating Budget for Fiscal Year 2017-2018 regarding the appropriation to the Boys & Girls Club (Department of Parks & Recreation — Kaua`i War Memorial Convention Hall), as I am on the Kauai Advisory Board for the Boys & Girls Club of Hawaii. In light of the above, I will recuse myself from the aforementioned item during the Fiscal Year 2017-2018 Departmental Budget Reviews, Budget Call -Backs, and Decision -Making, related to this item, and any subsequent meeting thereafter related to this item. Should you have any questions, please feel free to contact me. Thank you for your attention to this matter. JA:lc cc: April 12, 2017 Council Meeting Agenda County of Kauai Board of Ethics Council Services Staff Fiscal Year 2017-2018 Budget File AN EQUAL OPPORTUNITY EMPLOYER "Po 010141. 01 BERNARD P. CARVALHO, JR. Mayor WALLACE G. REZENTES, JR. Managing Director March 2, 2017 POLICE DEPARTMENT COUNTY OF KAUAI 3990 KAANA STREET, SUITE 200 LIHUE, HAWAII 96766-1268 TELEPHONE (808) 241-1600 FAX (808) 241-1604 www.kauai.gov/police Mary Tudela, Chair and Members of the Board of Ethics c/o Boards and Commissions 4444 Rice Street, Suite 150 Lihue, Hawaii 96766 Dear Chair Tudela and Members of the Board: DARRYL D. PERRY Chief of Police dperrv(a)kauni.eov MICHAEL M. CONTRADES Deputy Chief of Police mcontrades(alkauai.eov r+, Ili 8 2011 1 130ARi?3 $ CO SIOl4TS Rice Hoala Partners LP recently inquired about having a Kauai Police Department officer apply to be a "Resident Police Officer" at the Kaniko'o II senior rental project in Lihue. The officer would be provided a two bedroom apartment rent free for a period of one year. I am attaching the letter from Vykky Gamble, the EAH Housing Property Supervisor. As you can see from the letter, the officer would not act as a security force for the property and would have no obligation to perform any duty or take any action as a police officer. Ms. Gamble believes that the presence of the officer may discourage illegal activity. I ask that the Board of Ethics review Ms. Gamble's letter and the application and determine if the arrangement would violate the County of Kauai's Code of Ethics. Thank you for your consideration. Scerely I DARR L D PERRY Chief of Pol e Attachment AN EQUAL OPPORTUNITY EMPLOYER IM0 lie, W*0 4 A NOI....JPIT HOUSING CORPORATION February 9, 2017 Kaniko'o II 4215 Hoala Street Lihue, HI 96766 Phone: (808) 353-3938 Fax: (808) 353-3938 RECEIVED E FEB 13 2017 POLICE DEPARTMENT COUNTY OF KAUAI Darryl Perry; Chief of Police 3990 Kaana Street, Suite. 200 Lihue, HI96766 SUBJECT: RESIDENT POLICE OFFICER PROGRAM Dear Chief Perry, Rice Hoala Partners LP is seeking applicants for the Resident Police Officer Program at Kaniko'o II. We believe the presence of an Officer at our .Seniors Community will have a positive impact on the residents. We have attached blank application forms for officers interested in participating to fill out .and submit. Deadline for submission of applications is February 28, 2017. Please advise your officers that the program will provide a two bedroom unit rent- free for a period of one year. The lease will be extended an additidrial twelve months, if mutually agreeable to all parties. The selected officer will be responsible for the payment of the security deposit. The RPOP is loosely based upon the federal programs "Safe Neighborhood Grant" and "Officer Next Door" where police presence often discourages illegal activities. The program intent is physical.presence as stated, not to have the officer act as a security force for the. facility. Often, just having a police car in the parking lot is sufficient presence to discourage certain activities. We do encourage the officer and the Resident Manager to develop a relationship in which suspected criminal activity can be monitored and reported. Any relationships developed between the officer and the residents of Kaniko'o would be.a bonus to both the program and the police. -If you have any questions regarding this matter, please contact Vykky Gamble at 808-369-9247. ti Sincerely, Gamble, EAH Housing Property Supervisor RS-76386 cc: Makani Maeva, ABE Group lvivw.EA1W6using.org • Crewing c'ohnniaiiii, by developing, niairaging and promoting quality affi�rdttGle housing si�ic� 1968 2169 East Francisco Bh+d„ Suitt' B, Son Rafael, CA 9 f901 41S-2S3-1800 O 1001 Bishop .Vt., #2880. Honolnhi,, HI-96813 808=523-8826 February 9, 2017 Kaniko'o II \RPOPAPP 4215 Hoala Street Lihue, HI 96766 Phone: (808) 353-3938 Fax: (808) 353-3938 Resident Police Officer Program Now Accepthg Apphtions for Kaniko'o I I The purpose of the Resident Police Officer Program is to provide police presence at the rental project by having a Kauai Police Officer reside at the project. The management and residents benefits by the Officer's presence, which deters criminal activity, and the Officer benefits by having the use of an apartment unit rent free for about one year. The Officer is responsible for their own internet and cable and a cleaning deposit of $970.00. Kaniko'o 11 is composed of one and two -bedroom apartments for seniors aged 62+. The owner will provide a two bedroom unit free of charge to a sworn Officer in good standing with the Kauai Police Department at Kaniko'o Il. The term of the free Iease will be TWELVE (12) months with an additional twelve (12) months option to extend, if both parties mutually agree. The term could be longer if no other eligible KPD Officers desire to participate. The participating KPD Officer is under no obligation to provide security or any other service for the project in return for the free rent. However, the participating Officer and the Resident Manager at each project are encouraged to develop a mutually beneficial relationship regarding criminal matters suspected or perpetrated at Kaniko'o I and IL Preferences below are utilized to assist the Management Company in its selection of the Officer for the rent free apartment. The Officer with the highest number of preferences will be offered the free apartment unit first. Call Vykky Gamble at 808-369-9247 if you have any questions. Please answer the following questions and return to EAH Housing by 2/28/17: Name 'Work Phone No. ---------- FIRST MIDDLE RQ UAL LAST SpouseName Number of Children: (or SignificanT'0lhe# RRSL MIDD.E_INITIAL LAST Mailing Address STREETNUMBER TOWN STATE ZIP CODE Current Home Phone No. Work No . Cell Phone No. Preferences: I . OYes ONO Are you currently assigned ablue & white take-home vehicle? (10points) 2. OYes ONo Do you serve in the Patrol Services Bureau? (1 point) 3. OYes ONo Are you a Patrolman (Beat Officer) or Traffic Safety Officer? (I point) 4. OYes ONo Do you have a total household of 2 -4 persons? How many? (I point) 5. OYes ONo Is off street parking acceptable to you? (1 point) KAUVI COUNTY BOARD OF ETHICS DISCLOSURE STATEMENT INSTRUCTION SHEET I. WHO MUST FILE. The Mayor, Council persons, Prosecuting Attorney, all department heads and deputies, members of boards and commissions, the purchasing agent, and all candidates for elective office. II. WHEN TO FILE. Disclosure forms must be filed within thirty (30) days of taking office or within seven (7) days of fling nomination paper as a candidate for office, as in the case may be. Section 3-1.9, Kauai County Code 1987; Section 20.04, Charter of the County of Kauai. III. WHAT TO FILE. Charter §20.04 says you must file a list of all property in which you have a right, title, or interest, a list of all business firms which contract for county business in which you have any interest, all places of your employment including part-time employment, all sources and amounts of income, business, ownership, officer and director positions, debts, creditor interests in insolvent businesses, and the names of persons represented before government agencies. IV. AMENDMENTS. Disclosure forms must be updated within thirty (30) days of any change in information requiring disclosure. V. PENALTY FOR FAILURE TO FILE. A violation of any provision of the Code of ethics of the Charter of the County of Kauai shall be cause for fine, suspension, or removal from office or employment. VI. WHERE TO FILE. All Disclosure Statements should be filed by mail or in person, addressed as follows: Kauai County Board of Ethics c/o Office of Boards and Commissions Mo`ikeha Building 4444 Rice Street, Suite 150 Lihu`e, Kauai, Hawaii 96766 We suggest you make and retain a copy for your personal records. DISCLOSURE FORMS ARE PUBLIC RECORD tpjo 1*740 001 BOARD OF ETHICS COUNTY OF KAUA`I DISCLOSURE STATEMENT THIS DOCUMENT SHALL BECOME A PUBLIC RECORD AFTER THE BOARD OF ETHICS HAS EXAMINED IT AND DEEMED IT TO BE COMPLETE I. GENERAL INFORMATION NAME: (Firs t) (Middle) (Last) Name of spouse: POSITION TITLE: Indicate your elected or appointed County position, Board or Commission, or the public office you are filing for: I am a Candidate for Public Office: (Name of Public Office) I am an Elected or Appointed official for Kauai County: (Position Title) I am an Appointed member of a Board or Commission: (Name of Board or Commission) II. EMPLOYMENT — List all employment other than County employment (including part-time) Employer Position Source (Required: name of company) Current Annual Income (Round to the nearest $10,000. If more than $100,000, you may list > $100,000) IV. BUSINESS INTEREST — List all business, partnerships, or sole proprietorships and the percentage of interest in which you have an interest (please identify acronyms appropriately). Business Name Percent Ownership Interest Check here if business contracts with the County FJ V. POSITION HELD IN BUSINESS OR ORGANIZATION — List in the space below the information requested for all organization (whether corporations, non-profit corporations, unincorporated organization, partnerships, etc., and identify acronyms appropriately) in which you are an official of the organization (for example, president, vice-president, secretary, treasurer, trustee, agent, board member, etc.) Organization Name Position Address/Location Tax Map Key Number VIII. REPRESENTATION BEFORE GOVERNMENT AGENCIES — List the names of all persons, corporations, organizations, partnerships, etc. that you have represented before any government agency, (Federal, State, or County) board, or commission in the last five years: Name of person, company, etc. Board/Commission/Agency Year X. CERTIFICATION —MUST BE SIGNED IN FRONT OF A NOTARY PUBLIC I hereby certify that the above statement made by me are true, complete, and accurate to the best of my knowledge and belief. I further understand that if I acquire or possess an interest that might reasonably tend to create a conflict of interest with my duties or authority, or I or a member of my immediate family, which includes parents, siblings, spouse, or children, is an owner, officer, executive director, or director of an organization in any matter pending before me, I shall make full disclosure of the conflict of interest and shall not participate in said matter. Signature Document Date: # Page Document Description: Notary Name: Circuit Subscribed and shorn before me this day of 20 Notary Public, State of Ha:nai `i My Commission Expires: