Conflict of Interest
Statement for RCPL Officers, Trustees,
Committee
Members, Staff Members, and Certain Consultants
Policy: (1) No member of the RCPL
Board of Trustees or any of its Committees shall derive any personal profit or
gain, directly or indirectly, by reason of his or her participation with the RCPL
Board of Trustees, without disclosing same to the Board. Each individual shall disclose to the RCPL
Board of Trustees any personal interest, which he or she may have in any matter
pending before the RCPL and shall refrain from participation in any decision on
such matter.
(2) Any member of the RCPL Board, any Committee
or Staff shall refrain from obtaining any list of RCPL donors for personal or
private solicitations purposes at any time during the term of their
affiliation.
Required: At this
time, I am a Board member, a committee member, or an employee of the following
organizations:
__________________________________________________________________
__________________________________________________________________
Circle
any of the following circumstances that are applicable:
(1) I (or my company, employer, or
organization) am a participant, directly or indirectly, in an arrangement,
agreement, investment, or other activity with a vendor, supplier, or other
party, doing business or potentially doing
business with the RCPL which has
resulted or could result in personal benefit to me.
(2) I
(or my company, employer, or organization) am a recipient, directly or
indirectly, of salary payments or loans or gifts of any kind or any free
service or discounts or other fees from or on behalf of any person or
organization engaged in any transaction or potential
transactions with the RCPL.
If
1 or 2 above is circled, then stated below is a full description of the
transactions and of the interest, whether direct or indirect, which I have (or
have had during the past year) in the persons or organizations having
transactions with the RCPL. I agree to
refrain from voting on or attempting to influence such transactions.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Date:______________________________
Approved
by:
Signature:__________________________ ___________________________
Printed Name:_______________________
___________________________
Board
President
4/08