DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE, COUNTY OR MUNICIPAL ELECTED OFFICIALS. Check the box that applies and provide related information where needed D The Person Doing Business with the County is an individual and there is no familial relationship between this individual and any Cook County employee or any person holding elective office in the State of Illinois, Cook County, or any municipality within Cook County. DX The Person Doing Business with the County is a business entity and there is no familial relationship between any member of this business entity’s board of directors, officers, persons responsible for general administration of the business entity, agents authorized to execute documents on behalf of the business entity or employees directly engaged in contractual work with the County on behalf of the business entity, and any Cook County employee or any person holding elective office in the State of Illinois, Cook County, or any municipality within Cook County. D The Person Doing Business with the County is an individual and there is a familial relationship between this individual and at least one Cook County employee and/or a person or persons holding elective office in the State of Illinois, Cook County, and/or any municipality within Cook County. The familial relationships are as follows: Name of Individual Doing Business with the County Name of Related County Employee or State, County or Municipal Elected Official Title and Position of Related County Employee or State, County or Municipal Elected Official Nature of Familial Relationship* If more space is needed, attach an additional sheet following the above format. D The Person Doing Business with the County is a business entity and there is a familial relationship between at least one member of this business entity’s board of directors, officers, persons responsible for general administration of the business entity, agents authorized to execute documents on behalf of the business entity and/or employees directly engaged in contractual work with the County on behalf of the business entity, on the one hand, and at least one Cook County employee and/or a person holding elective office in the State of Illinois, Cook County, and/or any municipality within Cook County, on the other. The familial relationships are as follows: Name of Member of Board of Director for Business Entity Doing Business with the County Name of Related County Employee or State, County or Municipal Elected Official Title and Position of Related County Employee or State, County or Municipal Elected O...
DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE, COUNTY OR MUNICIPAL ELECTED OFFICIALS. Check the box that applies and provide related information where needed □ The Person Doing Business with the County is an individual and there is no familial relationship between this individual and any Cook County employee or any person holding elective office in the State of Illinois, Cook County, or any municipality within Cook County.
DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE, COUNTY OR MUNICIPAL ELECTED OFFICIALS. Check the box that applies and provide related information where needed □ The Person Doing Business with the County is an individual and there is no familial relationship between this individual and any Xxxx County employee or any person holding elective office in the State of Illinois, Xxxx County, or any municipality within Xxxx County. □ The Person Doing Business with the County is a business entity and there is no familial relationship between any member of this business entity’s board of directors, officers, persons responsible for general administration of the business entity, agents authorized to execute documents on behalf of the business entity or employees directly engaged in contractual work with the County on behalf of the business entity, and any Xxxx County employee or any person holding elective office in the State of Illinois, Xxxx County, or any municipality within Xxxx County. XXXX COUNTY BOARD OF ETHICS FAMILIAL RELATIONSHIP DISCLOSURE FORM □ The Person Doing Business with the County is an individual and there is a familial relationship between this individual and at least one Xxxx County employee and/or a person or persons holding elective office in the State of Illinois, Xxxx County, and/or any municipality within Xxxx County. The familial relationships are as follows: Name of Individual Doing Business with the County Name of Related County Employee or State, County or Municipal Elected Official Title and Position of Related County Employee or State, County or Municipal Elected Official Nature of Familial Relationship* If more space is needed, attach an additional sheet following the above format. □ The Person Doing Business with the County is a business entity and there is a familial relationship between at least one member of this business entity’s board of directors, officers, persons responsible for general administration of the business entity, agents authorized to execute documents on behalf of the business entity and/or employees directly engaged in contractual work with the County on behalf of the business entity, on the one hand, and at least one Xxxx County employee and/or a person holding elective office in the State of Illinois, Xxxx County, and/or any municipality within Xxxx County, on the other. The familial relationships are as follows: Name of Member of Board of Director for Business Entity Doing Business with the County Name of Related County Employee or State, County or Municipal Elected Official Title and Position o...
DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE, COUNTY OR MUNICIPAL ELECTED OFFICIALS. Check the box that applies and provide related information where needed
