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Haopt, or grant agency approval of policies, standards, or (" YES <br />guidelines for the agency, or for any subdivlslon thereof? <br />C NO <br />Serves in a start capacity with the agency and in that capacity participates in <br />making a governmental decision as defined in Regulation 18702.2 or performs r YES <br />the same or substantially all the same duties for the agency that would other - G` NO <br />wise be performed by an individual holding a position specified In the agency's <br />Conflict of Interest Code under Government Section 87302, <br />DISCLOSURE DETERMINATION [Checkone]: <br />If you answered "yes" to any of the above, the consultant is considered a "Consultant" pursuant to the Political Reform Act <br />and must file Statements of Economic Interest. <br />( Consultant is performing a specialized or general service for the city, and there is a substantial likelihood <br />that the Consultant's work product will be presented, either written or orally, for the purpose of Influencing <br />a governmental decision. As a result, Consultant shall be subject to Disclosure Category "1" of the City's <br />Conflict of Interest Code. <br />If you answered "no" to all of the above, the consultant does not have to file Statements of Economic Interest. <br />(; Consultant is exempted from any disclosure requirement because Consultant does not meet the definition <br />Of "Consultant" under the Political Reform Act or due to the extremely limited scope of duties under this <br />contract. <br />Department Director Signature (required) <br />Date Signed: May26, 2015 <br />