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HomeMy WebLinkAbout2017 (2) A, TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check one): /Over18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Committee/Departure t Approval ate Volunteer Signature Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Elm/Ie F Jry) si' bk (,S; L e/P.jki Name Name ('Z &e . �?I (Ares JvP. Street Address Street Address City, State, Zip Code City, State, Zip Code Y) I a rt )A Home Phone Number Home Phone Number 9 -*315-2-L4g? Cell Phone Number Cell Phone Number h I A h l lr, _ Business/Other Phone Number Business/Other Phone Number 2(a;ne . o�1ry, QAIS��� �. c;�r► f � NORTH q � tt LED 6 O � # ,T SSACHUSE TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978)688-9557 E-mail iradshaw(u�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, L& a- ,�1',�g�l��10 , of the . A#Jdoi1eg- 0d J:bIgg1 61_JAAf1 Z- (Print first and last name) Board or Committee Hereby acknowledge that on, �,j je&h ,4 2 _-t_S, �/ 7 , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. t Signature: i NORTI-� * t _ h n0 �q cocrc nwcw ' 41 SSACHUs���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail Bradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, LR_(,5T1tjF_ of the T�14r1&1 tJti Pt9 it (Print first and last name) Board or Committee SSUc 1 c�fe Hereby acknowledge that on (t%7 , I received a copy of the following documents: Open Meeting Law Guide _ Summary of the Conflict of Interest Law X Public Records Guide V I also have taken the r quired Oath Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: ,r"' t' b"""""1�.'.+°W s"`"" } ✓'Hi P 'Y`1�rJ,: m v. w - .✓'7. i `F � �..1`' �. �i. ,�. b •••� .16. ¢ ,`r' IM�Gr�4 LL.. .*6 x_ i uu a fR ,. � mF. y.��A,a � w a.. 4MM x o #� cer*ate of Comykdon � State Ethics Commission Conflict of Intearest Law qum %ngeco M has com Ceted du Con ict of gnterest iaw ,,:•` � 5,��; onCine training program on10 f ,. 9/12/2017 �.- At o + ,ir n tea°+ '� 1 ;r•m. `' '1..�« y# '`^wv. � �'�.u✓ wtwq � "F..�+�.uauz� y ._ �...+$ Ff LXR�� �°+.b°��,.^' PrintClGse • .pia.�e WindGw Certificate i Certti ate of Comp k on St2te cs Commission Conflict of Interest Law rf t 4 1-4 has compktedthe Conf fact o_f gnterest"w ,,,�'• _ r;-� online training,program on { 9/8/20 17 Print "� i Certificate CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, 4 /. x .� who qualified as a member of the Name) �G1� l' ',�/,�`J2_J✓7� 1 /r D f'eOl �erYify pursuant (Public Body) (Date) to G.L. c. 30A,§ 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. I �Z/— — &4 2.1� A ?1y6 (Name) (Name of Public Body) 1 2 ZC) (bate) Pursuant to G.L.c.30A, §20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. AIAV2017 Certificate Certificate of a { S} 1{kQ�l7 fission i Completion Conflict of Interest Law Nancy Boshar j- f Teaching Assistant School Department Town of North Andover has completed the Conflict of ,S�f-;`�� Interest Law online training program on R 11/15/2017 t RetumtoD=Form �[4 ;proq.etfi.state.ma.us�at)(#1_popups_and_menus_certificate_certifcare.ht�t Ifg Q* NORTH q QL O �xl �9SSAC H U TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978)688-9502 Town Clerk Fax (978)688-9557 E-mail Bradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, p7�iL :&irlo , of the y. keewF,,vr1.mJ (Print first and last name) Board or Committee Hereby acknowledge that on d a , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: / 12/5/2017 Certificate s Certif icacte of �Con� Yetton 3 SUu CS COR3RIISsion a� Conflict of Interest Law O.ollp 313roWn Administrative Assistant North Andover Public Schools i North Andover, MA lja; completeb the Conflict of 31ntereot Kahn �S'f% online training program on 12/5/2017 Print Return to M Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 ,49 Oelw SUN cs Commission Conflict of Interest Law �lz�Oe e, Custodian North Andover Public Schools North Andover hay,confb&Ec,Me 6'oi�� online ti�aiiu'�rq,�.�i•�ra�z o� f 9/7/2017 Print Close e o http://www.muniprog.eth.state.ma.us/page554968.htm1 9/7/17, 9:46 PM Page 1 of 1 1 Certif icate of Co letion Conflict a t.erest Law Ronald Bertheim Constable Constable Town of North Andover ,Ma has completed the Conflict of Interest Law online training program one 11/1/2017 - 9/14/2017 Certificate w Certificate of S ,tg Commission Co m l et i o n Conflict of 11hterest Law Virginia L Burns Teacher Assistant School Department ! North Andover Public Schools .` has completed the Conflict of �11_1' Interest Lawi l J online training program on 9/14/2017 'ss OR "M PrigRetum to Data Fcrnro Gertffica6e http://www.mu niprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 11/11/2017 Certificate iMAIM< r �a Certirf ica�te of Completiron State E cs Comm)ssion Conflict of Interest Law �pYer �uor�o�ane j Skate guard Town of North Andover Youth and Recreation Services North Andover ba,5 completeb the Conflict of 3nteregt lab, online training program on =If f �l i s 11/11/2017 J' S fi f� FfiFt Certific;Wm= �►-13SPHJVSSVW LZ :g �%'V OZ AON LM -�— -f � S' 1 4Ci S.is� i. Mi„ G.3A1w3-,_J p10RTF� O 71 �9SSACHUSf- TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshawnatownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE _ 104'-rv'9 lj , of the��1j b �0i a A (Print first and last name) Board or Committee Hereby acknowledge that on PTEM�£fZ 9 , ,�,O( 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law _ Ix_____ Public Records Guide X I also have taken the required Oath o ffice ministered by Joyce A. Bradshaw, Town Clerk on this date. Signature: q 's117 � NORTN q.wf J O`�t`ED 16 YO O p �y DR1TfD rPP��y SSACH�`'� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMCNT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, 1rf_L ]�Ut&6 - �02— , of the T" Anl&1l(U6 60.K> (Print first and last name) Board or Committee Hereby acknowledge that on _ E M r3F (9 , c?( 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide Y _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: pORTH O�ttLlO ^6 btiO 1�� 6 �L OTID a ��SSACHUSE��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshawAtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, c ClQccd_&�b , of the C0 i0C1 1_ 0l✓ /7Girtl�- (Print first and last name) Board or Committee Hereby acknowledge that on aT4aF(_ I d. a2 Q/7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law x Public Records Guide V I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: NORTH O��SLlD '6 910 6 02 OL 1 M ��SSACHIJS���h TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978)688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshaw(ii)townofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH[ OF OFFICE I, �iv�✓�= ��T� , of the , f � /F �r��,�� �urs�° ������(Print first first and last name) Board or Committee Hereby acknowledge that one f�dP �`/ d D 7 I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: ( ;��,�_� �, IL_ et r CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, I —RATE ,who qualified as a member of the (Name) tut :r-i :fir r}Kcri H6 v ISe, �,on �h y17 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L.c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. / 1 kJ41k e , az� (Name) >.,eevI d t-;,ie _t FY4yc Et �nv';S4;,Cr (. W///of F� (Name of Public Body) (Date) Pursuant to G.L. c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body,or their designee. NORTH Ob�z`ec '6q�0 o M �9SSAC HUS���h TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �iA U K1_ we u o e , of the -- (Print first and last name) Board or Committee Hereby acknowledge that on to%�:� /y �?D i , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide v" I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �,! F- CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, i-P,K L -�2►�to cZ_o who qualified as a member of the ((Name) 11 �)F r:lti �E.tvfl n t Ss6rH YTt)yIsu�_,l ( on 16y�J certify pursuant (Public Body) 'J (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L.c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. r (Name) (Name of Public Body) /4'//' 9 /7 (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. 8/22/2017 Certificate ert f icate of ���. �><Comm���� Co I et i on a p j Conflict o nterest Law Emilio Beato Spanish Teacher North Andover Public Schools North Andover has completed the Conflict of Interest Law online training program on 8/22/2017 Print,"""., .�R �l�!! Window�w C�rt�cate - http://wvvw.muniprog.eth.state.ma.usipage554968.html 1/1 Certificate 1113117, 11:28 AM Certi " ate of Com ktion Scats cs Comm ssWn Conflict of Interest Law Laura Bradbury Teacher School Department North Andover has completed the Conf l�ict of gnterest ;'��•, Law h online traininA progAram on January I , 20 7 PratCertificate-W-indow cerW)CSb http://www.muniprog.eth.state.ma.us/page554968.htmI Page 1 of 1 8/24/2017 Certificate ' n r r r � s Certtf icacte of ( COMPIet ton r State Et ics Commission egg w Conflict of Interest Law ewfi .� � �etna�i,o� e�✓i,c�ayt A 3 Sa bao completeb the Confltct of Utereot Rai online training program on 8/24/2017 S 4�. Printy cerwicate http://www.muniprog.eth.state.ma.us/page554968.htmi 1/1 a , Certifitate of Completion States 1GS Cofr€ lss;;an 3 -Ca Raren 313rfintner a46R .5 Teacher's Aide North Andover School Department North Andover bao tompleteb the Conflict of 3ntereot 3.abu Online training program on '1 8/29/2017 print ,i Certiate Certificate Page 1 of 1 V Certificate of Completion State as Commission s Conflict of Interest Law ,�ICOYC �QYt�rC Kitchen Manager North Andover Public Schools- Food Program North Andover bag tompleteb the QConflitt of 3ntereot XaW online traintng program on 9/7/2017 Window http://www.muniprog.eth.state.ma.us/page554968.html 9/7/2017 NORTH OF,ttiaO ie'9'4 2 ' •a � 0 �RssACHUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshawAtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, W j►_L i+R L-LA H 60 C__L•�i" , of the 000Nc I L li tj Adl tMJ! (Print first and last name) Board or Committee Hereby acknowledge that on ©cToP.£P_ (a{ Ao 17 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Y Public Records Guide )_ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: l 6/�0//tl pORTH 9I 3�0 �1lED lb•arOL V ' E 0 A SAC H 05 �5 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(a townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, S f 1 L��'D n Coto , of the (Print first and last name) Board or Committee Hereby acknowledge that on It 1''11'7 I received a copy of the following documents: Open Meeting Law Guide V Summary of the Conflict of Interest Law Public Records Guide z I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: pORT►y A ?0 �tleo 16�61'O O p �.9 �R17o♦PP�.��J SSACHUS, TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, cJ C C r O—C) C 0 , of the (Print fi st and last name) Board or Committee Hereby acknowledge that on 9 —0 " 1 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide _—Ll I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, who qualified as a member of the (Name) on certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. Alen (Name) (Name of Public Body) 10 ��Zv1 � (Date) Pursuant to G.L. c.30A, §20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. � �10RT►� q O tt�eo b 1• O � �9Srap SACMJ`-+Et�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the �N/hl� (Print first and last name) Board or Committee Hereby acknowledge that on Ck hPf 101 Zo 1 � , I received a copy of the following documents: Open Meeting Law Guide _ Y _ Summary of the Conflict of Interest Law Public Records Guide V I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. 0 Signature: I tiORTH O tS1"a'6 q�O 0� 4 N M1. TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(i�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, kLno CIysciA , of the.,�ZaNI0c Arb a A rpe AL-5 (Print first and last name) Board or Committee Hereby acknowledge that on , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law V Public Records Guide k I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: � NORTH q O �T�eo r6 „ , O a OL O A 4q M �. 7R 6AAV". SSacHU TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail BradshawAtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, F_i)Q142b �4?0io iLQPQ , ofthecV A\ip6,zF2 )-taysrrJG Avi 1aarzr,r y (Print first and last name) Board or Committee Hereby acknowledge that on ro�� 'f� , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide r/ I also have taken the requir d Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �_reM -�a�v 9/4/2017 Certificate Ce.?*atu eComykdon Stat! cs Comm ssion Conflict of Interest Law has com kud the Con id of 2ntsrest law onCine training grogram on 9/4/2017 Print Close Certificate Window Certificate http://www.muniprog.eth.state.ma.us/page554968.htmi 1/1 ' NORTH °�t<LeD 16 O 0 - i S q°gArm°neap,(5 SSACHUSE� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail radshaw(iitownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Z�r2y.�OjJ ��.✓wC�f'� , of the (Print first and last name) Board or Committee Hereby acknowledge that on._ Z�2,-f,ok,,--, /y ,���j , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide .;' I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 's 1, �`� r�titi�f�-5 who qualified as a member of the (Name) r t ti i f,Wins i Jr nk cN C T(1 V ISO" on_ r�fl y % certify pursuant (Public Body) �_ (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L.c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. Certificate < ' 1 w riw�'�•.. � rr (' Certif irate of p. I Sate Ethics Commission Completion i t ti t �r Kereen Cranston Noon Attendant North Andover Public Schools + } North Andover Public Schools has completed the Conflict of f Interest Law onl ine training program on 7/2 8/2017 _.'1 ..� 1r ., r. �� - `. �! "' T "M • r Psi I Print Certificate http://wm.muniprog.eth.state.ma.us/page554968.html Certificate Page 1 of 1 f y Certif irate of Completion E State Ethics Commission 2. Conflict of Interest Lam F �30-epa coop Administrative Assistant North Andover High School North Andover ` bay completeb the Conflict of lntere!5t lain online training program on 1 j 9/13/2017 ✓'ss, 1 >>`'' . 9C IT maw DAN PrintReturn to . . Form Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 9/13/2017 Zerttftcate of �Caomc retton f State Et ics Commission Conflict of Interest Law a a'. Mebra Conti Admnistrative Assistant 1 } North Andover High School Guidance Department North Andover Public Schools l ba.0 cotnpleteb the (Conflict of Intereot lad online training program on w{ 1 a } 9/15/2017 A Or nt Certificate 7/11/2017 r y Cerfift"Cate of Complettolt Sum cs Comm scion Conflict of Interest Law , 0(h ou Corarum90 Focus Counselor North Andover High School North Andover Public Schools N bag completeb the Conflict of NtervO lawO online training program on w =I 7/11/2017 It 3 wl -N--�M a. Print Close Certificate Window Certificate http://www.muniprog.eth.state.ma,us/page554968.html 1/1 9/21/2017 Certificate n Certti ate of Comp kdon sca cs Com ttion Conflict of Interest Law Doreen Che ie 1 st Grade Franklin School North Andover Public Schools has completedtFi.e Conf kt of InWestlaw onCim training program on F 9/21/2017 �s ` , w Retum to Data Form http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 9;20/2017 Certificate t i L Certi ' ate ComYcedon State lcs COMMIS ion i s Conflict of Interest Law ' N 2Cise Chisholm E Teaching Assistant School Department E Town of North Andover has com Cowdthe Con ict e gntmst Lary ' s` Y online training program on t 9/20/2017 Prim Return , Data F orm Certificate http:Hwwwjnuniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 Certificate 9/13/17,7:30 PM ` Certi ' ate o Com Cetion l p State cs Com ssion Conflict of Interest Law Denise Colman Teacher North Andover Public Schools North Andover Ihas completed the Conf ict of gnterest `-�� S'r Law r online training pro ram on September 1 , 917 ,`'SS, M Fs Print Return to Data Form Certificate http://www.muniprog.eth.state.ma.us/ao0l_popups_and_menus_certificate_certificate.htmi Page 1 of 1 �eLfI�!C9;s a\SO\J�, JO:J3 VW Certf ate oComykuon �t�t� o�Corn �`fon Confliet of Interest 1419 ECen Couf os Substitute Teacher North Andover Public Schools North Andover has com le-ted the Con ict of gnterest Law online traffiffigyrogram on 9/20/1017 t i l f fh:l k MMAA-i i in iiihi na-r,ri I'?fq rR,i l lq*np..\gr)ni hnhnha ql in iiinimp. nAt fI I If.q fq C.ri fl l lf.q fq'i i f I i i I t,qa. 1 ni c Certificate h Cem ' ate eComykdon Mate ics Commission Conflict of Interest Law Joseph CCar& Principal North Andover Public Schools North Andover has completed the Conf lfict of interest law online training program on 9/1/2017 Print Certificate http://www.muniprog.eth.state.ma.us/page554968.htmi I i I �c . ,6D TOWN OF NORTH ANDOVER 0 VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am(check one): Over 18 years of age Under 18 years of age (Parent/Guardian Consent Required) I know of no reason, medical or otherwise,which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Committee/Department Approval Date Volunteer Signature Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Name Name Street Address Street Address 06 Ay�,d OvK-r , MA- Eq City, State,Zip Code City, State,Zip Code g Home Phone Number Home Phone Number ° 74 -- L 8- 1� 4< -- q 9 a — '-(a-30 Cell Phone Number Cell Phone Number qn_ �13�T Business/Other Phone Number Business/Other Phone Number 9/13/2017 Certificate t w. Certi ' ate of Comp k on State CS Comm SSicn Conflict of Interest Law r 3uCw Caterino Teacher's Assistant Early Childhood Center North Andover Public Schools has comyktud t& Conf&T of Interest law ;"�~ C\. online training grogram on f 9/13/2017 e e Print Retum to Data For Certificate http://www.muniprog.eth.state.ma.us/a001__popups_and_menus_certificate_certificate.html 1/1 ` Certi ate of Comp k on State s Commission Conflict of Interest Law Teacher's Assistant-Michelle Downey has competed the Conf Pict of Interest Law W f online trainin rogram on 9/3/2� 7 �s:s�. , �;•4� Close Certificate ., 9/14/2017 Certificate I qq r �ertif 'racte of �tCompletto ' State cs Comm ssion Conflict of Interest Law Warbara 01nn Monoban Nurse School Department North Andover Public Schools baq completeb the Conflict of Inteee$t Ram online training program on 9/14/2017 r °X p inn hmmr m � Rrirrt' Certif cde http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmI 1/1 12/1/2017 Certificate r r Certtf tr cote of Cotupletton lion �tAS4 Conflict of Interest Law Cric 3Dobertp f Staff ---null--- North Andover Youth Center ba.q cotnpleteb the Conflict of Intereot RaW �ti C\-.S16,�`G online training program on v, 12/1/201 r Print Certmcde http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmI 1/1 Certificate Page 1 of 1 a ` Certif icacte of Completion ssarto S COM ion a Conflict of Interest Law Tarp lRarren �DiobaW Board Member Board of Library Trustees for the Stevens Memorial Lib. North Andover, MA jag coamleteb the Conflict of Intereot dab, online training program on J 10/11/2017 Print - _ t toData Form Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 10/11/2017 p10RTF/ 0� tLID 6 q�O O t A ��SSAC H►1`-+E��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE t I of the�jaa R cQ o f &&. 14 (Print first and last name) Board or Committee Hereby acknowledge that on I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS �ll who qualified as a member of the (Name() &CIP-d C2-C I I, PG � = on certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) 10,40 o (Name of Public Body) iv 5s ( ate) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. VAORTH 0*St4ID 16��0 3? y° - 0 o � � / �SSACHUSE��� ((// TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, iJMI !)Q L bf- l�,) , of the Cootic 1 L- 60 _A61 &6- (Print first and last name) Board or Committee Hereby acknowledge that on 0cC?t'�f.0- 1 1), v�01 , I received a copy of the following documents: Open Meeting Law Guide S� Summary of the Conflict of Interest Law V Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: i CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, 661k, who qualified as a member of the (Name) ri, on /qtoLiq — , certify pursuant (Pub c B dy) (Date) to G.L.c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) 4 (Name of Pubic Body)(Date) Pursuant to G.L. c.30A, §20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority, city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. 8/30/2017 Certificate tiF Certftan eComvkdon state its Commission Conflict of Interest Law Tanya 9 aceffi Dussault teacher North Andover Public Schools has completedtFi.e Conf fact of Interest law online training program on f J 8/30/2017 Prim lose Certificate Window� Certificate http://www.muniprog.eth.state.ma.us/page554968.htm1 1/1 ,4 -P," 11 TOWN OF NORTH ANDOVER �) / VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am(check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason,medical or otherwise,which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees,I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Committee/Department Approval Date olunteer Signature D to Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Name Name Street Address Street ddress /olmv / City, State,Zip Code Q1�,1 `— City, State,Zip Code �'?� Sod- /- --VP '1 0 Y 7� 3 2 d - lI Tome Phone Number Home Phone Number t Phone Number Cell Phone Number ass/Other Phone Number Business/Other Phone Number ah a¢ at A Certi " ate o ComyCetion t t- V 4 Sate Et ics Commission E r, Conflict of Interest Law : ZCatfierine DAY , , 4 r LTS Teaching Assis WW4 NORTH ANDOVER PUBLIC SCHOOLS NORTH ANDOVER has com feted the Con ict of Interest Law online trainingprogram on 9/26/1017 ul \l\l^ Print Return toForm Certificate TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am(check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason,medical or otherwise,which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees,I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. / //, 617 Committee/Department Approval Date 1 er Signature Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information muqa�,�� W tvu- DF ( e-"-0 P e4A A rf-� Name Name Street Address }} Street Address lf4— A 0 1r-q At,- � ou -eA A� City, State,Zip Code City, State,Zip Code 1)'Y'11 Y �Jc� q1Y '?ds S��a Home Phone Number Home Phone Number 9)- s' 0� (�J- 1/l3 Jj'W Cell Phone Number Cell Phone Number S Business/Other Phone Number Business/Other Phone Number NORTH OF�t�in + OL O i A SSA TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(dtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, ALAINErlf Id. bz,,tilvo , of the CLIat idell _ ad fd124( L�ic�ti�Glc- (Print first and last name) Board or Committee Hereby acknowledge that on�P�7���k°� a-5 0 "gall , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �� y/,, L) o rc n TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am(check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason,medical or otherwise,which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees,I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Committee/Department Approval Date 'Volulfreer Signature Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Name Name Street Address Street Address City,State,Zip Code City,State,Zip Code Home Phone Number Home Phone Number cj 7 9- 36ti-S3 {a 4,12 Cell Phone Number Cell Phone Number Business/Other Phone Number Business/Other Phone Number f NORTH H Q St Leo 61 �O O D SACHuse��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(a townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �64 R Y "t i N& ­Dz! LA tj 6) , of the kl i✓u�od�°,e &AVx4( (Print first and last name) Board or Committee Hereby acknowledge that on�7z°rn fjP� c?S, , I received a copy of the following documents: Open Meeting Law Guide V— Summary of the Conflict of Interest Law _ Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: lb41 i-7 �10RTIy V/ 61 3? 4`',' •R 6 OL To �4SSAC 14USES�y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, k ti kISe_.0 - , ofthe " c TI()ti butjc( L- (Print first and last name) Board or Committee Hereby acknowledge that on {_��d fP OAt &k 01$. d6j 7 , I received a copy of the following documents: �— Open Meeting Law Guide X Summary of the Conflict of Interest Law _ Public Records Guide x I also have taken the required Oath of ice administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: , . i Certi " ate oj Comp kuon State ics Commission fl Conflict of Interest M&n"htlEagan Instruct-iortaiL8itppert Staff North AndevcaAnbkic Schools r NeMnMdower has completed�the Conflict o Interest /r f r Law online trainin rogram on 12/18/ 17 Return to Data I Cerfifitate of Completton State cs Commission NOR AS Conflict of Interest Law Oanalb R. CUM Member of Board of Assessors Assessors Town of North Andover MA bay contpleteb the 'Conflict of 3ntereot Rai online training program on I 11/7/2017 � s Print Return to Data Form Certificate CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, J u T CE -i;0 Ro u) who qualified as a member of the (Name) Cv :BaP, u on /0 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) 10 Ott " C 7 (Date) Pursuant to G.L. c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. NORT{� O�Stleo 6 gti0 OV/A 4q °R�re°DPP y.(5 �SSACHUSE� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail Bradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, L�/ ��J , of theT✓V/�I �omrni �C (Print first and last name) Board or Committee Hereby acknowledge that on / / 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: t►ORT►1 9 / 0 AtLED 6 L O A 7q DRA 7ED PPP�.�� SSACH1`�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(cr�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �/'i�F� �i ��o of the /` es%1r02 (Print first and last name) Board or Committee Hereby acknowledge that on 17 / I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: l CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, �&2 /`—i91�'�'Jy who qualified as a member of the (Name) ,� -!e7 k on /0%7 f 7 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. �-7� (Name) /S, _r (Name of Public Body) lel7 1,7 (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body, or their designee. OR tAORTH ti�ec ib'q•t,� * 1 ��SSACHU`�E��� 1i TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(a)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Fib 1 G//�✓ , of the �A (Print first and last name) Board or Committee Hereby acknowledge that on /a /7— J7 , I received a copy of the following documents: Open Meeting Law Guide / Summary of the Conflict of Interest Law / Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. �f Signature: p►ORTH q O tLeo 161 ti0 ..6 �L 0 �9SSACHu5���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail Bradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, lRR`f f�/ X LFe , of the �IpA(ZD aF &111A7-1/ (Print first and last name) Board or Committee Hereby acknowledge that on ­�,EIVR£2 � I received a copy of the following documents: Open Meeting Law Guide } Summary of the Conflict of Interest Law X Public Records Guide _X_ I also have taken the required O f Office administered b y e A. Bradshaw, Town Clerk on this date. Signature: pO0 . ./ p tt�e -:e�Epp VV 3? be M1 p L F p �o °* �9SSACHUSE��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail jbradshawC&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE , of the 4C12,-L i i (Print first and last name) Board or Committee Hereby acknowledge that on �g�J�oy� ,� �, /;7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law 15C Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: fF p10 R T!y j\�����{�• �(� iu. o 2111 ocT 12 YQ�� OF �9SSA C HUSE�,�S Y1 Ass ACH U _' °c TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(u)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,-atb&e-'k �/-/6 JIG , of the C'��.•�ti cat de a,0S_9fZ VA LA V,' (Print first and last name) Board or Committee Hereby acknowledge that on _ �y �,?lfi' , I received a copy of the following documents: Open Meeting Law Guide _ Summary of the Conflict of Interest Law ' Public Records Guide �e, I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: %J 31,E Certificate of Completion F Stag cs Comm scion Conflict of Interest Law kriotp fautber Kitchen Utility School Dept. Franklin Elementary School hag completeb the Conflict of Intereot Xabo online training program on =` f Ir � 9/22/2017 �'SPrint Return to Data Cem ' ate eComykdon Stage "ics Commission Conflict of Interest Law 'C crck- J t=r )' nK U4 k 3c nd A ov tr Nor er, �� Q has completed the Conf lict of gnterest Law � online training program on 8/30/20175 �= yr - Print 1167T'��� `� Certificate a Certi " ate of Comp k on State cs Com ssion : r Conflict of Interest Law Liza Fontaine Teacher North Andover Public Schools has completed the Conflict of Interest �4jL Law f _ online trainin pprogram on 'o 8/8/2�I7 I TO POW Print CloseiertficateWindow Certificate ] L _._. Addholik- certificate of Com tetion Stat• ICS Comrt1l85ion (( �. Conflict of Interest Law 9 Liza Fontaine Teacher i North Andover Public Schools has com Cemd the Confict of Interest faw t online trainin pprogram on 8/8) 7 41 Print,.,: !Close Window Certificate �UY TOWN OF NORTH ANDOVER 1 7 VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am(check one): ✓ Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason,medical or otherwise,which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. ((l Committee/Department Approval Date Volunteer Signature Date Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact IInnf'ormation /fQNN K. �i+�1C�� XA-r-r\c6v Name Name /io ,ruUA4, l/o F4I(X4 �Co Street Address Street Address Iva, AfvP Qv6t m 4 o t ��� NU, Alypow- /'-ri+ 0)9L-tJ' City, State,Zip Code City, State,Zip Code 9-7P C F S 9)W 411 12-17 Home Phone Number Home Phone Number 4"4p . F3n— 1 zy 3 CO3 L,7J- Y3 Cell Phone Number Cell Phone Number Business/Other Phone Number Business/Other Phone Number Certificate of Completion State Et ics Commission Conflict of Interest Law Rana �'apab Substitute Teacher North Andover Public Schools Town Of North Andover S bao completeb the Conflict of 3ntereot KaW online training program on 1 24 2017 J6S 4C'` 0/ / Certif irarte of Complefion State E cs Commission Conflict of Interest Law Rana jFaVab Substitute Teacher North Andover Public Schools Town Of North Andover baz completeb the Conflict of Intere.5t KaW online training program on ti s � .. Fly 10/24/2017 `. � �' � �,. \.. �..+� "\..��=ter'' �,:�" "'�.,.,,o�',,. •,+...�., �,�-�', Print Rourri to Data Form Certt icate 9/22/2017 Certificate Certificate of sum S CommissionCo m le t i o n Conflict of I serest Law Sarah Forward Grade 4 Teacher ---null--- North Andover Public Schools has completed the Conflict of Interest Law online training program on 9/2 2/2017 ... http://www.mu ni prog.eth.state.ma.us/a001_popu ps_and_menus_certificate_certificate.html 1/1 CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the (Name) on 6 — certify pursuant (Public Body) rifE ( (te) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name(Name of Public Body) 7 (Date) Pursuant to G.L. c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority, city or town clerk, or the executive director or other appropriate administrator of a state or regional body, or their designee. tiORTH I 9gacmwc '.oK P`a �9SSACHl15��h TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MATH STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978)688-9502 Town Clerk Fax (978)688-9557 E-mail jbradshawatownofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE f o the-0 W C tt � Pe'1-�N2 IL''IYi�.Tr�(i���l�'T &M►N . (Print first and last name) Board or Committee Hereby acknowledge that on_D' c-50 bF 2 13; a p i7 I received a copy of the following documents: Open Meeting Law Guide _X Summary of the Conflict of Interest Law -_ Je — Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: 9/10/2017 Certificate J .; 4JJ Certificate of Completion State IC5 Commission Conflict of Interest Law 4az conpreteb H)c Coidlict of Interest law r. online training prograin on 10/2017 F"M Close Certificate Window ord" lte http:/Miww.muniprog.eth-state-ma.us/page554968.htrrl 1/1 vStatos Certi ' ate Cori �pmmission Conflict of Interest Law ,{ yy, � � 7 has completed the Confffa of gnurest Law `'•S . online training grogram on v�• a 9/11/2 017 ,.,%Kim ,. Print �. Certificate Certificate Page 1 of 1 1*2=MM&4knift Certificate of Completion ". Vol. ^m,ss r F Conflict of Interest Law ��jri�tine �aebe Teaching Assistant 4 Atkinson Elementary School 6 North Andover Public Schools . ' bay completeb the Conflict of Xntere.5t Kayo online training program on =` f I 8/31/2017 .. Print Close Cerlificate Windowi Certificate http://www.muniprog.eth.state.ma.us/page554968.html 8/31/2017 a Certificate of Completion state ics Commission Conflict of Interest Law Rpan Ouilb Instructional Assistant ---null--- North Andover Public Schools bay completeb the Conflict of IntereOt Rain online training program on =� 9/14/2017 aim -�&- Wrt Print Certificate tAORT11 O ,LID I q O L � M ATE J. r � Y • M1`4 ACHU E��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(a�,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I of the,i.,��'N A i `�"� � B C,✓�R� Pociru'e' r 6A..' A 6 I nl G- (Print first and last name) Board or Committee Hereby acknowledge that on (17W&f(1 (U .2iO 7 , I received a copy of the following documents: Open Meeting Law Guide x Summary of the Conflict of Interest Law Public Records Guide k I also have taken the requir d Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. �J Signature: 4, `��Vzw r%�-- r � NORTH -9 p ti�eo e� ti0 O �9SSAC HUSe TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(c�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the ept/NC i L. 17A) A //,16— (Print first and last name) Board or Committee Hereby acknowledge that on OC T-e)A e Q j C,,.,7G/y , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law K Public Records Guide k- I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date n Signature: NORTI-� O��t�eo q V p L O ��SSACHUS���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(dtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,V141.rW`/AN1141 AjMrAFkA)h()JLC0�1�qu of the`/V. 4 Cl/P ('dhlga( &0NCiL� (Print first and last name) Board or Committee Hereby acknowledge that on ��{��ti� �j e R� ,?5 �1� G/ , I received a copy of the following documents: Open Meeting Law Guide _ 9 Summary of the Conflict of Interest Law IC Public Records Guide �L I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: iu 1 3�1,� 1 J � p►ORTH 3 0t-:•_ _ L O A .AC US TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, r ff A t Q1,Nb2A&- , of the _fG, 0j N 1 0A_ & 96( (Print first and last name) Board or Committee Hereby acknowledge that on S(219�e of �a E'►� 5 , 0( 7 , I received a copy of the following documents: Open Meeting Law Guide _ C Summary of the Conflict of Interest Law }C Public Records Guide Y I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: 560 k7 � p10RTFr q � et °• O ��SSACHUSE��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshawAtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, , of the o ,:02 ( o•�..�c (Print first and last n e) Board or Committee Hereby acknowledge that on I received a copy of the following documents: Open Meeting Law Guide ✓ Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: 6I f ol)oo , (� t"q�o �RIve, 9/21/2017 I MG_1534.JPG t kww tee,,. MIT- _ z '(DNt�WW.rr tt?t�.c9h stule_fiu.ua.�`�t301.� uns��nd rtsCnu's_cs'ti+(w 1 cerftreste,hlmt - -- �_ l 'Mitu VC0*U0ar "WacaYourhon)a1�QtkshoeDnlfiewamwkiW1, C rti i at o obi; Co, letio eres Shaun L. Holland 'y`��t,clain� fps;slant: Sc�ltalcil' F=r��nklin 5�[�cxl d��t has completer h Conflict of x«„ Interestr line_training program on An } https://mai1.google.com/mail/u/0/#inbox/15ea4ef9333af515?compose=15ea4e955dfc387t&projector=1 1/1 TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Cl X7 � Committee/Department Approval Date olunteer ture bad Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Name Name GG �o�, M/» o A//✓� / � itn J //✓C Street Address M Street Address /►.. 4 City, State, Zip Code City, State,Zip Code Home Phone Number Home Phone Number //7 )451<5 �03� �578 ) y3o -8V7S Cell P one Number Cell Phone Number ).gas 4!r!5► &/7)3.rS- V y Y Business/Other Phone Number Business/Other Phone Number MQ ;)( , 41 Certif irate of Completion Sate cs Commission Conflict of Interest Law Colette 3buabeg; ` . � Teaching Assistant North Andover Public Schools ' North Andover J ieteb the (Conflict of 3lntereot Xabo ljag comb � Wine training program on 9/10/2017 ��9J�� ,� ON '" ' •�, •�4 ,,'�� ' III ~4 I Print CertificMe Window tifi Cercate P i I 5 p1 O R TFi O��t�an ;6gti0 6 o � Z � y�9SSACHUS��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978)688-9502 Town Clerk Fax (978)688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the ^ X�i d�C/�.cT.o� (Print first and last n e) Board or Committee Hereby acknowledge that on �i 7 , I received a copy of the following documents: / Open Meeting Law Guide V Summary of the Conflict of Interest Law Public Records Guide ✓ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: � NORTN q Q ,fit LED i6 O A Vq w SSACHU`'t TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, C)WA/ . kfA6� , of the a (Print rirst and last name) Board or Committee Hereby acknowledge that on . a� / 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide J� I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signatu re: G NORTH A- O�StIEo .6�iYO ��SSgcHusE��y ��II OCT AM 7 TOWN OF NORTH ANDOVER NORTH;��y����-„ OFFICE OF THE TOWN CLERK '4SS, r'r ,- � 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE —f I , of the l fl,c�NUali T�f )�,PES��llpr/OrL���x�is ��' 'e �h�Ct, A�� (Print first and last name) Board or Committee Hereby acknowledge that on /t/, q c/7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law A Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: J 9/11/2017 Certificate Certificate of Stater ictCommis>sion Co letion Conflict oRterest Law has completed the Conflict of Interest Law online training program on 9/11/2017 Print Close C Certificate http://www.muniprog.eth.state.ma.us/page554968.html 1/1 e� Certi " ate of Corn.p lettion stato ins commis$,on Conflict of Interest Lave Debra gfoover Teaching Assistant i i i has com feted the Conflict of 2nterest .haw online tra%nin program on ,. 9/12/M 7 i .dvmk� AWOL AWL, AOL. Certi ate of Com fetion State t ics Commission Conflict of Interest Law Debra q-foover Teaching Assistant S has com_ feted the Conf ict of gnterest Law onCine trai1n//din/j�A�(/\�1p7rogram on 9/12Y V 1 / v � cer*atu of Comykdon State ics Commission 4 Conflict of Interest Law 3enner glafforan Second Grade Classroom Teacher North Andover Public Schools North Andover h., completed tie Conf fact of gnterest La►v 49 1 online trains ogram on >a ` 9/15/2017 '�° ` 9/21/2017 Certificate ON Certi ' ate of Com �etion p stsne: Ica Com Sion Conflict of Interest Law Wrismn Tfamwey 1 st Grade Franklin School North Andover Public Schools F has comyCmdtFi"e Conf &T of ZnUTest-Caw onCine training program on r 9/21/2017 ��s�s,1 t� Yi. ' Retum to Data F F K mu a 0 http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 7/12/2017 Certificate kI � r E Cer*atp, of Comykdon Staff ics Commission Conflict of Interest Law N has com feted du Conf is of Interest law � jL, onCine training program on r y ` , 7/12/2017 r Print , + Certificate http://www.muniprog.eth.state.ma.us/page554968.html l 1 Certificate of Comp tetion Stata cs Commission Conflict of Interest Law Sheila E. Tfe ernan Elementary Art Teacher School Department North Andover has compfetedthe Confict of gnterest f" r Law ►f;' j� online trainin program on 8/3/2qI7 q � +,�^+^;+j,-*� ,» � .� � € �..�. rr rrq � ,:� ♦ .�fx -r r re r`y 'aN"t r ,i�+�1 � f�:- Print �. Certificate O ` rti " ate o Com lesion Ce p Scats ics Comm scion Conflict of Interest Law Debra gfoover Teaching Assistant has corn feted the Confict of Interest .haw onCine trainin program on 9/12/ 17 r 9/20/2017 Certificate s: Certificate of six. "s`°mmi3s'°n Com letion Conflict of I terest Law Anne Iovanella Speech Language Pathologist Franklin School North Andover Public Schools Jr., S/r: has completed the Conflict of Interest Law online training program on = 9/20/2017 � 0 ME AD ;- �K-0-w- j Fria �� f Certfficate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 8/30/2017 Certificate w ri 1 Cer*atu eComykdon taste es Commission Conflict of Interest Law E - € has com, kud the Cone ict of Interest law � u onCine training program on r~ 8/30/2017Close Certificate Window f .w � Y http://www.muniprog.eth.state.ma.us/page554968.html 1/1 ------------------------------------------------------------------------------------------------------------------------------------------------ ACKNOWLEDGMENT OF RECEIPT I, L C'V- V-zr\ �' �� , an employee at F L-(,-,— , (first and last name) (name of municipal dept.) hereby acknowledge that I received a copy of the summary of the conflict of interest law for municipal employees,revised November 14, 2oi6, on 7// 7 ( ate) Municipal employees should complete the acknowledgment of receipt and return it to the individual who provided them with a copy of the summary. Alternatively, municipal employees may send an email acknowledging receipt of the summary to the individual who provided them with a copy of it. ;7"�i_..� � _. fib. d` <1!`•.. `.,. ♦♦ b / .�KT y ti ' � 1�'`r�• *s ij�.. �4� r t�y abr jr.y.Aw ���.�aw i�. �V' �''r_ �y ���1' �+. F Cer*ate eComykdon State Ethics Commission F Conflict of Interest Law : cuj r has comykud the conflict of Interest Law online training program on �- 8/30/2017 A j_� Print Certificate NORTH 0 A � i SSACHUSEt�y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail jradshaw(iDtownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, 1), &i)L- A,/)f NT-T4_ , of the YOAII a/6 IlA�� 42 S/11_.1WL (Print first and last name) Board or Committee Hereby acknowledge that on ® 0 , I received a copy of the following documents: Open Meeting Law Guide V Summary of the Conflict of Interest Law Public Records Guide ✓ I also have taken the re uil.e Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: pORTH O SLED q� 3? yt�;: +°•a �L 0Too m �9S5gCHU`�E�g9 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshawntownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �a��iJi� K/ 1A �'A���/ , of the(Print first first and last name) Board or Committee Hereby acknowledge that on ll�c f�1�Pw /y �?I)/ 7 , I received a copy of the following documents: Open Meeting Law Guide c� Summary of the Conflict of Interest Law L. ' Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the ((Name) SA�(h H6 V r5c-2 on rVI yZl _ , certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) f (Name of Public Body) s Xz (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained,according to the relevant records retention schedule,by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body, or their designee. 14ORTH q * O o �. # �93 Arlo SACHUS���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978)688-9557 E-mail jbradshawC&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the (7 r n c rr1 =c it , jC- (Print first and last name) �^ Board or Committee C emm" e-, Hereby acknowledge that on zili 'C/v , I received a copy of the following documents: j Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide u I also have taken the re aired Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. i Signature: t CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS h_ � l Ili A who qualified as a member of the (Name) r e Ode C" 60� n certify pursuant (Public Body) (Date) (Mwr7 �� to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) L.-� (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. 9/13/2017 Certificate Ask, goal Certif icate of a Commission Co I et'on Conflict o terest Law Rose Marie Karigianis Teaching Assistant School Department North Andover Public schools has completed the Conflict of } Interest Law W f online training program on 9/13/2017 1 t Print Retwm to C Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 9/11/2017 Certificate Ce mj' ate eComykdon State ics Commission Conflict of Interest Law F., com[rM/feted�t& Conflict of 1nturestLativ J 1 � ' e onCine training program on 9/10/2017 l'ss •�� 154 Mu�__14 pr ".W--- -0 Print CiGse ' . ficae Window 1/1 http://www.muniprog.eth.state.ma.us/page554968.html 4 CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 1, �� �� who qualified as a member of the (Name) 1 nu7C1"C"l on 2 certify pursuant (Public Body) �C>�uuctT4--Q.� (Date to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) Y/.(/�� (Date) Pursuant to G.L. c. 30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body,or their designee. NORTH w1"- Qf St LEO ib�.r0 0 o p vq SACHUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, RQ a V Lc,(Vl 6vq of the `rt/ J LI Print first and last name) Board or Committee Hereby acknowledge that on '0�, 3/J+� , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide )( I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. i Signature: 4r CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS C.i ;: L- who qualified as a member of the (Name) S&J,i 10 , JrtC(N 06 vise)n� �• on _ !>�l certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h)and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body or which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office: (Name) (Name of Public Body) (Date) Pursuant to G.L.c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority, city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. NORTtj O S�eo 9 O — M SSACHU`+E��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(a townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH[ OF OFFICE r / I, /OTz -013fr , of the Sf"e'`. (Print first and last name) Board or Committee Hereby acknowledge that on /''r ?6/ Z I received a copy of the following documents: Open Meeting Law Guide ✓ Summary of the Conflict of Interest Law Public Records Guide v I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. } Signature: J r CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the (Name) 06 L/66,444 on I�Z/5Z7 certify pursuant (Public Body) f (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) c' �Vl�rru_�r„�l� 'AE'r ti sEnv',SlJk y l e"WI/i 77f: F- (Name of Public Body) y /7 (Date) Pursuant to G.L. c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. tAORTH O �S�eo '6q�0 OL 0 Too �9SSAC HUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(i7�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the (Print first and last name) Board or Committee Hereby acknowledge that one f�dP� /y, d D/ 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law , Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �' � f NORTH 'q,y 0 SACHUSE��S TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshaw(cr�,townofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the (Print first and last name) Board or Committee Hereby acknowledge that on ivXle'% 17 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath oZOce administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: R NORTH O L �O eyh ACHUS��A� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(i�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Nic-KO L �f&JNA N , of the o(d O'gd+e& C 1'4'6a►c _ je' . pvMw( . (Print first and last name) Board or Committee Hereby acknowledge that on OCT v0,,c 2 �+ D 1 , I received a copy of the following documents: Open Meeting Law Guide X. Summary of the Conflict of Interest Law u Public Records Guide K I also have taken the required Oath of Office admini stered by Joyce A. Bradshaw, Town Clerk on this date. " Signature: Co�3o 1�D , R CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the (Name) �r co" u t e,on /d /7 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L.c.30A, §20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. qv .1 pORTH .1�� 0t ,6'6 OL 0 J)) 71 � 9q ��SSACHUSE��� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(a)townofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, AA►�TI�A ����(!SC;� , of the O�� (Print first and last name) Board or Committee Hereby acknowledge that on OkTU Bi-2 13 , :,`(G' I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law 3C Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, bC f 1j)<'I ,A) who qualified as a member of the �j9 n 1 �� (Name) / (//i� Cr���T�.0 /7is/4Zi1` �i�T �1.�11ti on M11,2 certify pursuant (Public Body) (Date) to G.L. c.30A, §20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. \J (Na e) � (2,te >�s xa,, (Name of Public Body) %/,,2 (Date) Pursuant to G.L. c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. f NORTij O SSLeo 6'41, o .°~ g �9`rSACHl1S TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, C_MMC : Town Clerk Telephone.(978) 688-9502 E-mail ibradshaw(a�townofnorthandover com Fax (978) 688-9557 ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,_ r1C16ck �. Ai, C1 h , of the (Print first and last name) is7"��' ��5 T�r 6T CON M Board or Committee Hereby acknowledge that on 0c,T-0 Er"_ i.) , :)ri ./ , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide _ I also have taken required Oath o Office administered by Joyce A. Bradshaw, Town Clerk on this date. t Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the (Name) on certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L. c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, I/2dA J&UMSAI-f�f ,who qualified as a member of the (Name) �/i� lJD1�A/L/L 42A1 4/i✓66 on lLU i o , certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) L ouNC r aAl zL G- (Name of Public Body) X 01�i7 (Date) Pursuant to G.L.c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. 0F tkORTH q 3� �t�eo °� y0 O � t- m ACHUsa�ty TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshawAtownofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE , of the (.nan/efL t'In; .Aoir,;c:r (Print first and last name) Board or Committee Hereby acknowledge that on t/ -FQ i3�1 b ' C-'/7L3��1 b�r,(7 I received a copy of the following documents: Open Meeting Law Guide y Summary of the Conflict of Interest Law V Public Records Guide u I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �13o%U pORTH Of St LED ;b�tiO O SSA C H us TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(ai)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Z04A�.� / , of th F (Print first and last name) Board or Con&tteg Hereby acknowledge that on /L I received a copy of the following documents: / Open Meeting Law Guide 1/ Summary of the Conflict of Interest Law Public Records Guide i/ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signatur 1 r 14 tAORTH q 0 �tLED 6• �O O A �V/ h �40 cniCrew • 10 SSAC HUSA9 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail iradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, 4,ieON J Elme_-4 , of theta{' &dnd_9K L1 f ura A1)a/e1'1 (Print first and last name) Board or Committee Hereby acknowledge that on S 07�' d7e)/;7' , I received a copy of the following documents: V_ Open Meeting Law Guide Summary of the Conflict of Interest Law D< Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Sign atu� pORTH Q�ATLEu ib��O •6 0 o H �q �FA7E0♦PP'�.�y SSACHUS� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the (Print first and last name) Board or Committee Hereby acknowledge that on S Z6171 received a copy of the following documents: T / Open Meeting Law Guide y Summary of the Conflict of Interest Law Public Records Guide I also have taken the reqjuired,09th o Office ad ster d by J yce A. Bradshaw, Town Clerk on this date. Signature: t4ORTH Oct`°D 3? 4.. '• 0 o iL ED SACHU`�E��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(a,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, , i iJ , of the �ZonlI(k76 eeA l2� J)t- APACAL S (Print first and last name) Board or Committee Hereby acknowledge that on C 1 , I received a copy of the following documents: Open Meeting Law Guide �4 Summary of the Conflict of Interest Law X Public Records Guide _ V_ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: s CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, bovh�C,S LkA "Y1 who qualified as a member of the (Name) NOA WQ'A- �N aA on [,iD-10 111 , certify pursuant (Public Bo y) (Date) to G.L. c.30A,§20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L. c.30A, §20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority, city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. � pORTy q T�O 32 6.. •_ _ 0 QL � M '. 77 ?q �RSSACHUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk j Fax (978) 688-9557 E-mail radshawotownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE d..oL.1G- , of the N, A 1\]b0Vi-:2 f1 C. f r'i6 AuTKot2 ( T y (Print first and last name) Board or Committee Hereby acknowledge that on 5 /'/13�/� o� �CJp 7, I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law X Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. { Signature: "Teizm ac�aa, ��1'79)147-q,21,2. p i g��q NORTH T1 �+EIvCLJ Oftt�eo ,,�qo TO ' CLCR. ►,'S OFFiCE O ti A 2C-17 OCT 12 PM 2* 04 Ssgc►+usp��y TO k U e NORTH ANDOVER MASSACHUSE TTS TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshawna townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, -1Znl N )Y/VC d , of the dZ AldPPC& &A&f t 047-/U,41 (Print first and last name) Board or Committee Hereby acknowledge that on Sey07,1_^f&_'k _4Z ��//�' , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law 15C Public Records Guide I also have t en the r red Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: pAORTF# O tSS\,ED .6 q�0 RECEIVED TOWN CLERK'S OFFICE s fill OCT 10 AM 10: 33 �ppDRA7fD "`cy 9SSACHUS TOWN Or NORTH ANDOVER MASSACHUSETTS TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(u�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, DOLLY VjUC4VF �0LIA , ofthec:� 6Nkye2SchocI 0MM(rr (Print first and last name) Board or Committee Hereby acknowledge that on �eD 1-1 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law _ Public Records Guide '1�1 _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �� RECEIVEID TOWN OF NORTH ANDOVER TOWN CLERK'S OFFICE p1� OCT 20 VOLUNTEER O i 7 TEER SERVICE AGREEMENT 1 enter into this A i Of unteer uncompensated services to my Town and acknowledge that: H ANDom I am(check one):HASSACHUSETYS v Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. 1 will perform the volunteer service in compliance with the direction of Town Officials. Committee/Department Approval Date Volunteer Sign to Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information 41�111�7 '42z��v Name Name Street Addres Street Address City, State,Zip Code 611y, State,Zip Code Home Phone Number Home Phone Number q117f--(_fg117-1#1�Z 9�;�- ���- Sir Cell Phone Number Cell Phone Number r Business/Other Phone Number Business/Other Phone Number 9/21/2017 Certificate All VON %ft M. tin CeeComykdonMa Stall: ComM Saion Conflict of Interest Law 3udy -cawson 1 st Grade Franklin School North Andover Public Schools has com, kmd the Conf l&T of Interest f w online training grogram on J i 9/21/2017 `s:� Retum to http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 9/18/2017 Certificate ANIL r � � Certi ate eComykdon StiA! com sion Conflict of Interest Law Me8han Long Teacher School Department North Andover has compkwd t& Conf fact of Z ntrrest Lary online training,program on 1`4 r r 9/18/2017mill Print Retum to Data F tertiticae,, 771 http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate htm1 1/1 TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT 1 1 I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check one): YOver 18 years of age Under 18 years of age (Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. S vC I 7 Committee/Department Approval Date olunte Signa�ure Date Signature 1 give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information ')6nn1&t- �_"Z- Name Name Street Address Street Address City, State, Zip Code City, State, Zip Code Home Phone Number Home Phone Number Cell Phone Number Cell Phone Number , te17- ,-5 70 17�y Business/Other Phone Number Business/Other Phone Number , 1 Certificate 817/17, 9:31 PM wr " ` ff7. Cer*ate of Com feuon State ics Commission 1 } Conflict of Interest Law Erica Lopez akt '=�� Teacher Assistant S`1 { North Andover Public Schools North Andover, MA 41 V f has completed the Conf Pict of Interest A Law online tray inin rogram on 8/7/2� � Jr5si l``4` t Print e Close Certificate Window Certificate http://www.muniprog.eth.state.ma.us/page554968.htmi Page 1 of 1 • 1 111• ' - .fit '°►'` F .--.s K+ Cer*ate of ComyCetion S te E ics Commission ^ ` Conflictof Law has comyktrdthe Conflict of interest-law onCine training yrogram on 9/5/2017 q t 1�' • kTr Close Certificate Window • 4 - *•e• 0 1 1:• • of '• • II •• •• certificate3 EthicsLogo Certi ' ate eComykdon Conflict of Interest Law 1Cai din .Fundy Special Education Teacher North Andover Public Schools North Andover Public Schools MassSeal has compCeted dw Conf lfict egnurest Law onCine training program on 9/17/2017 Certificate http://www.muniprog.eth.state.ma.us/page554968.htmi f r - Certtf irate of Completion State Et ics Commission f i f - 3 Conflict of Interest Law _lobp Crap `lambert . Teaching Assistant North Andover Public Schools North Andover bA5 C011Ypreteb the CDritCitt of 3lntere!5t RoW � online training program on � ! 8/22/2017 1-4&V taW a 4•' ^ 444-1 � lt ...� .t Z...� �5..-. 44 "'Y Print "!! :' ,, Certificate 1 of 1 8/22/17,7:12 PM 9/14/2017 Certificate k L Certificate of StateE us Commission Com letion Conflict of I terest Law : Kristin Long Teacher North Andover Public Schools �t North Andover has completed the Conflict of Interest Law ,1 online training program on 9/14/2017 s Print ReSm. to Data Form Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 tkORTH RE*CEIi* u) O 1 C ; :ERK,'S OFF10c- ry 2011 OCT 10 AM 10• 33 � 9q , _ ��SSACHU`�Et�h TOWN OF Mn°ssac�ru�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshawC&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, -Ifk%k9Q)f HC_J I T_T , of the ( J, Av')DaU£_2'SClfba 0_0m(��Ilrrraz (Print first and last name) Board or Committee Hereby acknowledge that on I l? L( 1 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law 14-1 Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: NORTH JR`CEIYE: TW! CLEWS 211T OCT 10 All 10. 33 "SSACHUS��`y TOW14 (Y NORTH ANDOVER MASS ACHU!�, TTSTOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail Bradshaw(u�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,PM `1 ►g h `( , of the rl nf�0L`e.2 ,\cE-t66)L LUNbt(TT� (Print first and last name) Board or Committee Hereby acknowledge that on r,--- 4 �'1'?( j //, I received a copy of the following documents: oi Open Meeting Law Guide Summary of the Conflict of Interest Law X Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: r pORTN Q�Rt�fO O rn �9SSACHUSr- NORTH CA Joyce A.Bradshaw,CMMC ' Town Clerk Vt (W Ct(le- E-mail jb. -�4 ACKNOWLEDGMENT OF CE 5 1 n � 1,�n�G1� �(e- I _w2T'( ScJ0I'0_1U Ur2-1ri/ (Print first and last name) i5oara or Uommittee Hereby acknowledge that on 9/_2 /�2 �) , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law 1C Public Records Guide k/ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: I�P_I-xao� c °f pORTH q o 41 �9SS�1CHU5���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshawna,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, / 1 E L r)r)a f , of the CL2&1C1L_ (Print first and last name) Board or Committee Hereby acknowledge that on '�'pt""Wf he tL a0 I , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide x I also have taken th equired Oat f Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: — pORTH { r H EI,E O�0 t 2 pli 2* o 2��i Of� s, �9sSgcNu5 F } t' to CJ 1~ ASOOVER �F�4 SS;�C,�,.1 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(atownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE 1, 6,0-1"97- Z/14A,11/ o�, , of the yi, Aiydyilm AoA1s,_,,-xi1,fT14,t1 elo Yxf . (Print first and last name) Board or Committee Hereby acknowledge that on , fBiyl�f�° T2 del/7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Y Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: ` suJn rn /"7 TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. !/Ll Committee/Department Approval Date AVoluntee Signat re Date Signature 1 give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Vol nte er erContact Information Emergency Contact Information CIE L ame Name 3 K 3� 1,4& 2�A d 4C,z- Street Address Street Address City, State,Zip Code City, State, Zip Code �7r-JK-3b2l Z�7r2� 21 Home Phone Number Home Phone Number 7 f 7P l-�''3 3 Id- Cell Phone Number Cell Phone Number Business/Other Phone Number Business/Other Phone Number Certificate Page 1 of 1 Cerfift'rate of Completion Scan s Comfit Won Conflict of Interest Law 4114abetb Aarobaii Franklin School Nurse North Andover Public Schools North Andover bay completeb the Conflict of 3nteres;t RaW online training program on r! A 9/21/2017 J'S'E, . h Print Certificate http://www.muniprog.eth.state.ma.us/a001—Popups_and_menus_certificate_certificate.html 9/21/2017 Certificate 8/3/17,12:47 PM Certificate of Com tenon Slate Ethics Commission ' Conflict of Interest Law t ECtzabeth Anne ggcBride y� French Teacher North Andover High School Y' North Andover Public Schools has comyfeted the Conj'uct of Interest Law - f W,J ' online trainin pro ram on s 8/3/2�17 g ` SIM.! Print r Close f Certificate http://www.muniprog.oth.state.ma.us/page554968.htmi Page 1 of 1 Certificate of Completion 3 } State E ics COMMISStOn Conflict of Interest Law Raittin Atha Teaching Assistant Special Education North Andover bao completeb the Conflict of 3ntereot Raba - r--f } online training program on 8/21/2017 '1 14, —,1-, OW ON-001.1 t4p;4 54— 4 77 Print CisClose Certificatp w Ce�ificate Certificate Page 1 of 1 Certificate of Completton Salle cs Comm scion Conflict of Interest Law 31ean O.efroon Administrative Assistant School Department North Andover bao completeb the Conflict of 3ntereot XaW online training program on 9/14/2017 Print Return to Data Form Certificate http://www.muniprog.eth.state.ma.us/a001—Popups_and_menus_certificate certificate.html 9/14/2017 9/14/2017 Certificate Certti ateeComykdon State Commission Conflict of Interest Law Susan Murgo teacher School Dept. Franklin School has comp kud the Conf fact of gnturest law r on��ne training program on f 9/14/2017 Prin# Retu m to F at-a Form Lertic http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html li 1 CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 1, ANY NaLE y who qualified as a member of the (Name) nn "H &U lsva4 L, on i�/f / certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. -7 f0 (Name) (Name of Public Body) z (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body,or their designee. t4ORTM r e O 0 reD �9SSACHU`�E��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail jradshaw(a)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,T nT`( Pl L w� , of th c° (.J�(A z54, L.L4e/ nl " (Print first and last name) Board or Committee Hereby acknowledge that on 1cclyb/v /`/, �70/7 I received a copy of the following documents: Open Meeting Law Guide ✓ Summary of the Conflict of Inter t Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. \ Signature: CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS who qualified as a member of the (Name) k Ti- fu F ° ^ H U lSv on r z'/yZ7 certify pursuant (Public Body) (Date) to G.L.c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L.c.30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) SLI (Date) Pursuant to G.L. c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. NORTII � 6 1 M p 4C ��SSACHUS�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(i7,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH[ OF OFFICE I, /' K - '' , of the (Print first kid last name) Board or Committee Hereby acknowledge that on ��c f�flPfv �`/, U> 7 , I received a copy of the following documents: Open Meeting Law Guide x Summary of the Conflict of Interest Law y Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: V/ 1��� CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, H4C-Y11 L-L 0 N who qualified as a member of the ((Name) ��t .rZ1� fl �� Jsr�rzcH �l1 ULS&" L.on �Z/9ZJ certify pursuant (Public Body) , (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body or"which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) ��y)t'C I V!l t tlr�fa 'S;Aec bi L ?,111 771" F- (Name of Public Body) 4 zz (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. tkORTH q O tt�eo '6•ti� 0it rn A opt , AC Or- TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshaw(u townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the rf '-- (Print first and last name) Board or Committee Hereby acknowledge that on �t���f /% �,i , I received a copy of the following documents: Open Meeting Law Guide F Summary of the Conflict of Interest Law -m Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: L NORTH O`, (U%U 16�� O O A 7q 0"AT[O SSACHUSE TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I,_jysi_V5 R N c �(-rzTtfY , of the 00 vit i C i (_ OAJ Ad)tj C_ (Print first and last name) Board or Committee Hereby acknowledge that on c r'o gf —2D1Z , I received a copy of the following documents: Open Meeting Law Guide V Summary of the Conflict of Interest Law X Public Records Guide _ k I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: p10RTli OFtt�eo b�tio O � o � SACHUS� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail Bradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, A"E'a �i L�� , of the /V, �4e.' &J�iLIXA /L (Print first and last name) Board or Committee Hereby acknowledge that on �� I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. // Signature: Z&-I� /Pt4l ttORTH OFAt�eu �°gti0 OL O A b o � �a ORAiEO 'PP',�'�GJ SsHCF1U5E TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE n F-65 0San Cnf1P �1�1 , of the V(AI CC,MM , '�2P (Print first and last name) Board or Committee Hereby acknowledge that on 9 1 1 C� l ')01-7 , I received a copy of the following documents: Open Meeting Law Guide z Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: A's NORTH q O tt�eDrb•�O �9SSACHU`����� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(attownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, LRy-i-T P. MA lyz i J TF_ , of the 1&ri,ti c, aAk-b or= pP�ALA (Print first and last name) Board or Committee Hereby acknowledge that on , I received a copy of the following documents: Open Meeting Law Guide .X Summary of the Conflict of Interest Law X Public Records Guide x I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: Z 16 6/0 NORTF� �/ O�,SLLc 16��0 32 bt M 6 L O t � ��SSACHUs���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(a)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, &AA1eis T. - , of the �� �`t�l4s.YH (Print first and last name) a- Board or Committee /eaJiv 5/cI,*AJ Hereby acknowledge that on i 17 , I received a copy of the following documents: Open Meeting Law Guide Y _ Summary of the Conflict of Interest Law Y Public Records Guide \L I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: NORT{� O�St LID o 4q . �9SSAC NUSp'(�9 fc TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Jus'P/H �e LAB i j/y , of the 'ge ji:�! Gr ,CJ�iS►�Tti (Print first and last name) Board or Committee Hereby acknowledge that on � i,B�,e � _�D17 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law X Public Records Guide _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: /' NORTH "9 O �RSSACHUS�K�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120_MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshawta�.townofnorthandaver.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the LL (Print first and last name) Board or Committee Hereby acknowledge that on�j 0��_ � '12 u?'l received a copy of the following documents: Open Meeting Law Guide -4 Summary of the Conflict of Interest Law Public Records Guide X, I also have taken the required Oath of Office administered by Joyce A. Bradshaw,Town Clerk on this date. / Signature: µORT►i O`tt�eo ,6-1ti0 3} �O A tsgSSgC HUS���9 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshawra-).townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I' tl1CLtJ ._! '�1t7` , ofthe (print first and last name) Board or Committee Hereby acknowledge that on I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law4h° Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: Certificate Page 1 of 1 d. . . ,. e} e. < w .r a> i.. a. . we; _ .. _ � w .-ti- .w Y=_a.ss ,._�..C . .w, . •'+r.t_ A .«t;1"ti e A,; Certif icate of { .g State Ethics Coremission Completion F Teresa McManus W h Teaching Assistant School Dept Town of North Andover --1 has completed the Conflict of Interest Law online training program on 9/6/2017 ,,�` r/ra"z1 !A►: :` �� iA`# >� ?,AA Print ry Certificate http://www.muniprog.eth.state.ma.us/page554968.html 9/6/2017 ll i Cer*ate of Com k on State s Commission Conflict of Interest Law laurfe MaaarCane } Teacher North Andover Public Schools # t r. North Andover has com k wd dw Con is of gnterest Lary online training program on 9/14/2017 J',s: , t F� Print Retum to Data For Certificate Certificate 8/28/17,4:03 PM � c Cert� ate o p Com Cet�on State cs Commission Conflict of Interest Law _S Elizabeth McCarron Teaching Assistant tohas compCetedtFe Con ic f2nterest . Law online trainin program on y X 8/28/ 17 1 dry': Y+F' S� W ' Print i + NT' Certificate http://www.muniprog.oth,state.ma.us/page554g68.htmi Page 1 of 1 8/30/2017 Certificate CeMJ ateecomykdon Stato Fcs Commission Conflict of Interest Law Loy-eriej r'y) has completed the Conflict o.f Interest law onCine training,program on 8/30/2017 `:s5 d ' Print �� fi"� ' � ,� Certificate http://www.muniprog.eth.state.ma.us/page554968.htnil %� 8/31/2017 Certificate Certi ' ateeComykdon State t ics Commission Conflict of Interest Law Marion mako ELL Program Coordinator/Instructor School Department North Andover k y has completed the Conf fief of gnterest law onCine training program on J 8/31/2017 W-F e .. . n, w. Print i Certificate' http://www.muniprog.eth.state.ma.us/page554968.html 1/1 9/15/2017 Certificate Certificate of so Mss`°n Com letion P Conflict of Interest Law Laura Murphy Special Education Teacher ' North Andover Middle School I:t North Andover Public Schools '+ has completed the Conflict of � L,sz`f Interest Law online training program on 9/15/2 017 Print Retum to Data Form Geti�lcabe http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmI 1/1 e Ce?-Uftate eComrkdon ,cs Commission Conflict of Interest Law i has compCet d du conflict of gnterest.haw online training,program on �= 9/12/2017 E Print Close Certificate Window Certificate' \x/ \DTI! 1�►1 j 1,1F; s `,, 1i'! 1 1i Cen ate of Com Cetton I State Ethics Commission Conflict of Interest Law .'. Patricia Wett Teaching Assistant s North Andover Public Schools North Andover MA ' has completed the Conf ict of gnterest ' law onCine trainingA program on s f 9/13/TO 17 Print Return toData Certificate 9/24/2017 Certificate Ce t*ate eComykdon State fit'Ncs Commission 4 Conflict of Interest Law jud Wunan Third Grade Teacher Department of Education North Andover has com, ktrd du conflict of gnterest Law online training program on 9/24/2017 �Mimvzx MIA Pd nt Rrgtum to Data Form Cerfficate ,ittp://www.muniprog.eth.state.ma.us/aoOl_popups_and_menus_certificate_certificate.html 1/1 NORTH OF���en 6-14, 6 0 r CErVED p v TC-ty"N C! :..° ,' OFFICE * `T ► n e 211100T 12 PH 2: 03 ���QORAT"E 9SS4CHUSe� TOWN OF NORTH ANDOVER MASSACHUSUj' WN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, .4401//5 of the /l�. /�lGt�/>✓fie CC�iL�Sf,PG IT/C1/� 1iY. (Print first and last name) Board or Committee Hereby acknowledge that on : Or , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law k Public Records Guide Y I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: / Certificate Page 1 of 1 Certificate of Sam SCE 5�n Copletion Conflict nterest Law Dale Osborne Elementary School Library Media Specialist i North Andover Public Schools North Andover has completed the Conflict of Interest Law 7. £h online trainingg program on A 9/13/2017 's V.41]� V. M. Y L Close Certificate Window http://www.muniprog.eth.state.ma.us/page554968.html 9/13/2017 Certificate of Comyletion �k �.Ir yj rConflict of Interest Law Erin 4 j, 0loug ' hCin y�am•• '%;fi'`. r 7.w Assistant • NorthAndover Public • • t North • • Schools vv. f i 4 F has com/ / conflia of interest / trainingonCine / / - { '� 1 4 k,• t' Close Certificate Window i NORTH O -0%Ao 16 q�0 e 0 T p SSACHUS�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail radshaw(attownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH[ OF OFFICE I, l ,l4 t2 LS L l i�L 1 14-5 , of the bi16-41ehf - (Print first and last name) Board or Committee Hereby acknowledge that on r�% /j ,7�, , 'I , I received a copy of the following documents: Open Meeting Law Guide 4_ Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. a Signature: Y/ �� �/ OFt��eo 6 atio o p ��SSA C HUSEt,�9 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFh , of the �/�,Jll� (Print first and last name) Board or Committee Hereby acknowledge that on J t t�l LN 6 EQ l y, , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law X Public Records Guide X I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Ch on this date. 7 Signature: r�JE F�-rOb�t`eD*6 a�Op ECEI Y D TO C;.ERK'S OFFICE 2017 OCT 10 AL`i 10: 33ATED �9SSACHUS���h TON OF NORTH ANDOVER MASS ACHUSETTS TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail iradshaw(u�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFI( I, UF_L2: l NFUILtL ECKOL-b of the CY 0tgkt1Z2Sr_H6QL 000W (Print first and last name) Board or Committee Hereby acknowledge that on ;,0 17 , I received a copy of the following documents: Open Meeting Law Guide x Summary of the Conflict of Interest Law Public Records Guide K I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Cle on this date. s Signature: http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmI 9/13/2017 Certificate Certi ' ate eComyCMon star. s Com Sion Conflict of Interest Law ti gulie Pe krgast Teacher's Assistant 1 Early Childhood Center North Andover ha, com d. Cn ict o gnurest la►v �=�� . 5`f feted online training grogram on 9/13/2017 . Return to Data Forirm http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 Certif irate of State E ics Commission Com letion ,e x Conflict of I terest Law Me9 han Picanco Special Education Teacher . North Andover High School Forth Andover completed the Conflict of = ^ S' has p a Interest Law q online training program on 9/15i 017Print Return . Data Form ` Certi " ate of Com Cetion state tics Commission ' Conflict of Interest Law Megan Pinksten Guidance Counselor School Department North Andover has completed the Conf ict of Interest = Law online training ppro ram on September 1�3, 2�17 WIS Print Return to Data Form Certificate Certificate Page 1 of 1 Certifitate of Completion State Et 1.7 Commission i Conflict of Interest Law Rmber Varioeau Special Needs Nurse North Andover Public Schools i Essex County bad Completeb the Conflict of Interest 7atU online training program on 8/3/2017 1~17 Print Close Certificate Window Certificate http://www.muniprog.eth.state.ma.us/page554968.html 8/3/2017 TOWN OF NORTH ANDOVER VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check e): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) I know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. Committee/Department Approval Date Volunteer Signature Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact Information Emergency Contact Information Name Name 130 /Va-1A Street Address Street Address A 14 i'l,"�" AA 0��(S City, State,Zip Code City, State,Zip Code 617r- egg -bv�3 Home Phone Number Home Phone Number 617 -733 .CAM � l 7-5,t7-6�t`l� Cell Phone Number Cell Phone Number Business/Other Phone Number Business/Other Phone Number Certificate Page 1 of 1 l Certi f icate of stag s Comm scion Co eti on p Conflict o Interest Law Justina Padovani Teacher Thomson School North Andover Public Schools has completed the Conflict of L���a AL Interest Law online trainin rogram on pp 7/25 T 7 W &010, ai-4% �+►wdkate http://www.muniprog.eth.state.ma.us/page554968.html 7/25/2017 Certificate Page 1 of 1 vCfae, of Coplettonime t ct State Ms Comm scion Conflict of Interest Law Patti Vebro teaching assistant 3 j School Department North Andover hao conmpleteb the Conflict of 3ntereot XaW online training program on r r 9/14/2017 M-11"MIN Mr, i Print Return to Data Form Certificate http://www.muniprog.eth.state.ma.us/a001—Popups_and_menus_certificate_certificate.html 9/14/2017 9/13/2017 Certificate Cert0 ateeComykdon stats «coy, on Conflict of Interest Law Ellen Peters P.E. Teacher/ Lead Teacher at Franklin School North Andover Public Schools North Andover of has complet t6ie Confltict gnterestlativ �' S' � online training program on } 3 9/13/2017 }` Prime Form— Certificate http://wwwmuniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htm] 1/1 9/2012 0 1 7 Certificate Ilk Certi ' ate eComykdon State cs Comm ss on Conflict of Interest Law Zedeka Pokkgan Classroom Teacher School Department - Franklin School North Andover has com Cmd tfie Conf fa of gnturest Law `'` jL"5` - online training program on 9/20/2017 tt s _. Print Retum to Data Form Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 a CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, LF C, 0£TC R who qualified as a member of the (Name) < r N T � c ri U O.St" on_ toll ti'T , certify pursuant (Public Body) ci (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) c'i 'IyA4'c ti ILhv�SOk'y ��/�!/1i772" F (Name of Public Body) (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. 1 NORTH "1 Ot�sLSD , �70 0 M �• 4 °.fit �9SSACHUS���y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(iz-)townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �`E�✓ �f��-�.5 , of the , �9H� tc - (Print first and last name) Board or Committee Hereby acknowledge that on to�lPw /`/, C� 7 , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law t Public Records Guide X� I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. / Signature: 1 CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 1, C Kk S rt�JA I L L-I to—S who qualified as a member of the (Name)b�Ps.rZ �r �r r;r�cH 06 y IS6, ,on ��'1 y�7 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body o7 which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) �.Y1rFI ni f �-rk4G,( i ,4 ,,SL��2y �li/�lf�i 7-7;F- (Name of Public Body) �I/,/s L11 - (Date) Pursuant to G.L.c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body,or their designee. CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS ZCk WA PA who qualified as a member of the t (Name) T + vise eClk on 10 2 t certify pursuant (Public Bo ) . i(Dat ) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of off] e. (Name) (Name of Public Body) 16i2,L(/I 17 (Date) Pursuant to G.L. c.30A,§20(h), on executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body, or their designee. CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, who qualified as a member of the (Name) on certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h)and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five(5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L. c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule,by the appointing authority, city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. t%O R TH O ttt`1 D ,06,9�O 0 2 e �•9 oRATeD�PP,�'(y SSACHUSE TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, &U- 1yi �R65n_rl , of the Cott ti<_(L- 0n.1 (Print first and last name) Board or Committee Hereby acknowledge that on�_/G /J Q£42 10, j o l 7 , I received a copy of the following documents: Open Meeting Law Guide 1( Summary of the Conflict of Interest Law k Public Records Guide 1/1— I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: Certificate 11/28/17, 6:56 PM A. AI _ CZ• rX; r Certi " ate of Comp Cenon State E ics Commission Conflict of Interest Law Benjamin Ramos Employee North Andover Youth Center North Andover has completed the Conf riot of Interest .Law online trai//nin/(A/JM/rogram on 1 1/2V/LrV 1 / .S' 1• �01 40 tl t _ Print Return , Data , Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus certificate_certificate.htmI Page 1 of 1 9 102017 Certificate la Ibir v'q Cer*ate eComykdm staff cs Commission Conflict of Interest Law gloya glahgozar i School Department g ECC has completed the Conflict of Interest onCine training program on 9/10/2017 a PrintClose Certificate Window Certificate http:Nwww.muniprog.eth.state.ma.us/page554968.html 111 9/14/2017 Certificate ��5 !< Certificate of Coln lettort State ics Commission Conflict of Interest Law �C�jri�ttne �.obben NAECC Secretary ---null--- d North Andover Public Schools bay completeb the Conflict of 3lnteregt XaW online training program on 9/14/2017 i tti � IJ- M F a( Print , Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 Hello, My printer didn't work so I took a screenshot of the screen. Unfortunately, my information didn't appear in the certificate so I positioned it in front of the completed course with my info. A calamity of errors! I hope this suffices. Sorry! oil Directions: Please enter your Information into the fields below. The information you enter will be included in your certificate C a�t•nts ;errpt ' After completing all fields.click View Certificate to view and pnnt a Getting Started certificate of completion Then cLck the Next button to continue. ' - - { t.Conflict of Interest ..,..,_., 7 Certificate-Google Chrome — ❑ X Lew Overview --- -- -�-- -- ' CO 2.Gift Restrictions Lsz�obeK� �vv,, .muniprog.ethstat %e.maAis/page5548_htmi Your Name: - } 3.Seli-Dealing and Nepotism 4.Standards of The Name of your Conduct Municipality or District: 'o,n: 5or,h dcaer ' 5.Divided Loyalties � 6.Prohibited Financial The Board Or �}I� Interests in Contracts Committee you serve Vre>t rtfic�tre of �uut reri0It 7.Restrictions after on,or the Department ?, Leaving Public that employs you: School Gepadmegt ca Camimssion Employment i 8.Members of Commissions Conflict of Interest Law and Boards Your Position Title: Lunch Attendant Assessment Next Steps jjp%coutpleteb fly Conflict of Juteregt 111W �:`� 4 online trainutq progrant on U T ( 9/11/2017 pill • ' , 8/30/2017 Certificate cerftau of Comykdon Suto ies commission Conflict of Interest Law jn,-O\y Y-\ £ RukIph has completed the Conf fact of interest Law ;L, online training grogram on _ xp 8/30/2017 u Certificate hnp://www.muniprog.eth.state.ma.us/page554968.htm1 1/1 Certftatu o Com tenon State E ics Commission 9 Conflict of Interest Law Joseyh Ratte Mathematics Teacher North Andover High School North Andover has compfetecf the Conf iict of gnterest Law online train ro�ram on 9/14/inT7 Certificate 9/10/17,4:35 PM Certi ate o Com tenon p Stat ics, C.omrnission a Conflict of Ime es Law 8u ga Ce Robinson ELL tutor North Andover Public Schools Town of North Andover ° (as comyleted the Conflict of Interest r Law online training ro ram on = a September 1� 2� 17 Print Clow Certificate. ' Window Certificate http://www.muniprog.eth.state.ma.us/page554968.htmI Page 1 of 1 ....— -- . ._ 1 Certi ' ate of Comp k on State Commission Conflict of Interest Law Uicf=CRin zer Music Teacher Franklin Elementary North Andover Public Schools has completed the Conf fact of Intmst Lativ y� online training,program on ti~ 9/14/2017 ,r u I!a::a:F:c:rrj All r t "• .y �� I Certti ate eComykdon Sure I s ComisNill Conflict of Interest Law %Ughan Rivera Art Teacher North Andover Public Schools The Town of North Andover has completed the Conflict of ZntErest La►v online training program on r 9/14/2017 ,t - T ._.CIA Print Cert'ificate `K Certi ' ate eComykdon Stid�, Commission Conflict of Interest Law 1cay zoche Teacher Department of Education North Andover Public Schools has compCmdthe Conffact of gnUrestLary onCine training program on r r 9/20/2017 Print Certificate 9/20/2017 Certificate Certificate of k : S23C! IG5 Comm SSIOrt Co m letion • Conflict of I serest Law Darcy Rubino Special Education Administrative Assistant Special Education North Andover Public Schools has completed the Conflict of Interest Law online training program on r 9/20/2017 �� t y♦ Print Retum to Data Forin Cerlific http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmi 1/1 Certi ' ate eComykdon suto cs Commission Conflict of Interest Law .L�sa Riedel Teaching Assistant i North Andover Public Schools State Employee has comy pint fthe Conf��ct of Inwest law onl�lne training program on .- 9/22/2017 Retum to Data F Print V10 R TF/ OF t�eo ' q.( � °s O 0L 0 �0 .' 9SSAC HU5E� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �XN"1gj � OLSUj\Q\ , of the � 1 fu h r &ei ert, L DMf1r (Print first and last name) Board or Committee Hereby acknowledge that on tl 24 l , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the req ' ed Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: 12/7/2017 Certificate Certtf torte of Complettort state cs Comm ssion Conflict of Interest Law �.abp �enttate Staff Youth Center North Andover bad cotnpleteb the Conflict of Intere.5t 1aW G�� S�`%•G online training program on 12/7/2017 L sEIV 3!�, Print Certincde ti N http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 AMIAMOL V • eaAelol V V F s u, E COit11Sl1f iAtf Conflict of Interest Law Robin Sullivan Teaching Assistant U1lll/lPi t1YClilC/l�'`�l`Uf�'/`Ct/ll U/l 9/4/2017 g h11PWWNiM(Y'Ut1 pmgyth-state.ma.wgpaqe554968.htm; Jig OT 7:16 NO Page 1 of 1 8/30/2017 Certificate 3 cer*ateeComykdon `•'' State ics commission r ? Conflict of Interest Lave K b u- S � �r� ch at has com lendd tfw Con ict-of 2ntErest Law : online traffiffig grogram on J \ 8/30/2017 l 1 NE, •. ""��+�a '� Print fir.. .- .Certificate Window Certificate http://www.muniprog.eth.state.ma.us/page5.54968.html 1 l CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 1, �1��� " l � .�� �vGho qualified as a member of the (Name) /5 6,<J?la/, 3/!.1'1 A'-�Jt'Z on -12 - / certify pursuant (Public Body) (Date) to G.L. c. 30A, §20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations, 940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5) years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. e) All �/j (Name of Public Body) l ./ (Date) Pursuant to G.L. c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority, city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. NORTH O ,,LID 9V O ,n IL Z en qq 1. �9SSACHUSE�ty TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshaw(n�townofnorthandover com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, A N A.` �2'j )�,p �A r .Q r c I , (Print first and last name Board or Committee Hereby acknowledge that r J.4. _9,- , I received a copy of the following documents: Open Me Law Gui Summary of the Conflict of Interest Law V Public Records Guide k 1 also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: ~ t%ORTH q O 't ,to i6`tip 3� gE .' 6 OL IL n �9SSACHUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(i�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, 5 S i c O I T OJ6- (Print first and laFnam Board or Committee Hereby acknowledge that on 'r1C.- /0 10/7 , I received a copy of the following documents: Open Meet X Summary of the Conflict of Interest Law V— Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: v t CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, 'N I O S>P - l�-�,t who qualified as a member of the 14 (Name) on �a U /, ertify pursuant (Public Body) (Date to G.L. c. 30A,§ 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law,G.L. c. 30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable, a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of offic . Aa Name) ` q0jjV1 I t- OA,1h/l✓6 (Name of Public Body) /0 //D /17 (Date) Pursuant to G.L.c.30A, §20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority, city or town clerk, or the executive director or other appropriate administrator of a state or regional body,or their designee. t%ORTH A O �tteo ;6t.t.O h0 i "2 a ac 9SSACHUS�� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail .i bradshaw(a,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, _�11�i��i I ty� `\ Tr(�f_i �F� , of the I-A -� r'A.0 IJZ�2 14D05(t�j 6 /407-1 ()r, f i y (Print first and last name) Board or Committee -6+,+e--A�Pv r n�'T�_17- Hereby acknowledge that on , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature• & p10RTH 9 0 �tLED /61 tiO .1�2 a°` •-.�. a OL 0 m l,j:CF_1'YE1D ivE - F cry S 11, OCT 12 SS A U TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, , of thei✓e�aca a2e6ia i/f�T/D/r/ �•'`7�• rint first and last name) Board or Committee Hereby acknowledge that on ��f��yQ�ie ����p/ , I received a copy of the following documents: Open Meeting Law Guide u Summary of the Conflict of Interest Law k Public Records Guide y I also have taken the required Oat of Off e administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: �1441(t1 W //, I/ 10/20/2017 Certificate .............. fCertifirote of Completion Sum COM iiaat Conflict of Interest Law (fart (f 6benb!9en Board of Trustees Member Board of Library Trustees, Stevens Memorial Library Town of North Andover bay completeb the Conflict of Interest Rabe �Ns!�� Sic,��, online training program on 10/20/2017 s� � 11r R*tum =� ! i��t3�5SbW U3&O�J V N1SON 210 FI1t4O1 0C =b WV EZ 130 till Oii J0 S.A4-31; i cM01 a3A1333V http://w,Aw.rTuniprog.eth.state.ma.us/a001_popups and_menus_certificate certificate.html 1/1 -------------------------------------------------------------------------------------------------------------------------------------- ACKNOWLEDGMENT OF RECEIPT I, `.-- r�rn SV �/t�5 �.� ,an employee at 7?-W J v tZ- /VC,r�?2f (first and last name) (name of municipal dept.) hereby acknowledge that I received a copy of the summary of the conflict of interest law for municipal employees, revised November 14, 2o16,on to Z4- ;Lo I -7 ate) Municipal employees should complete the ackttawledgmettt orreceipt attd return it to the itdividual who provided them with a copy of'the sttnimmy. Alternatively, municipal employees may send art email acAltowledging receipt of the summary to the individual who provided them with a copy of it. 31�OQ�d HIVON oC =6 Ez 130 t A13 0 9/11/2017 Certificate t Certificate of State CS Carn stti+on Completion Conflict of Interest I aw x has completed the Conflict of Interest Law online training program on J `. 9/11/2017 Ali ; �ti T _ �....,w. .,,,.�►- ,. Print Close Certificate Window Certificate http://www.muniprog.eth.state.ma.us/page554968.html 1/1 8/22/2017 Certificate rF aCerttf tcacte of Complet "ton State res Comm salon Conflict of Interest Law C1�a�nc�na a SY val�ava hag completeb the Conflict of Interegt Kab, online training program on s 8/22/2017 01141 OM Print Close Certificate Window Certificate http://www.muniprog.eth.state-ma.us/page554968.html 1!1 9/18/2017 Certificate , 1W! ti� �Ts1• 4 Cei atu of Com k on State Ethics Commission Conflict of Interest Law 4 Dianne Stevens Administrative Assistant + High School Guidance Office North Andover Public Schools t + has comy�et�c�the Con�lct of interest Law `~ t / ' online training program on A 9/18/2017 ��'� �. ,/l�ii �IFif4l�l C�il�41� , .t <«. �5►l4` t 1���' ��' print Data Fornn cortittcate hill)://tvtvw.muniprog.ethslate.ma.us/aOO l_popups_and_menus_certificate_cerlificate.html 1/1 a Certi ateeComykdon Stag cs Commission Conflict of Interest Law qff ary Stasonis Web/Media Facilitator North Andover Public Schools Town of North Andover has completedthe Conf fact of Interest Law onCine training program on 8/22/2017 r� M PrintCertificate CertL ate of Com Cetion Tara Sarmento Teacher Assistant North Andover High School North Andover Public Schools has completed t& Conf liict of gnterest Law F� online trainin program on 9/27/Y017 Print Certificate 9/15/2017 Certificate .Certificate of Completton F I y Stan cs Comm ssion i Conflict of Interest Law givappfua 6abi Teacher Assistant Franklin School 3 North Andover School Department 1 bag completeb the Conflict of 3lntere!gt 'Lab) online training program on v a 9/15/2017 P Cortffica6M http://www.muniprog.eth.state.rna.us/a001-Popups_and_menus certificate certificate.htM t ORicsComrr.i�sl,', Certi " ate o Com Cettion pstan `- Conflict of Interest Law Christine Schena 1 Kitchen Manager Food Services North Andover Public Schools has completed the Conf Pict of gnterest Law f online trainin program on 9/21/ 017 1 JJr - S Silt t ,\�4 Print Return to Data Form Certificate Certificate 9/17/17, 5:17 PM Ak Cer*ate of Corn tenon p Y State ics Commission t Conflict of Interest Law Lynne D. Scott Third Grade Teacher School Department Town of North Andover has completed the Conf ict o.f gnterest 1 �'~ ;'�r•� .Law _ f onCtne trainingA roram on September`1 , 2�17 5lit 01N,Print Return to " Data Form Certificate http://www.muniprog.eth.state.ma.us/aO01-popups_and_menus_certificate_certificate.htmI Page 1 of 1 Certificate http://www.muniprog.eth.state.ma.us/page554968.htmi Certifkate of Cont letton State E ics Commission Conflict of Interest Law CJh 1 S bay completeb the Conflict of Rtereot Katz online training program on 9/8/2017 z e- Print 1 Certificate 1 of 1 9/8/2017, 8:29 AM ' � '1 dV!�, ��� ,J � � '' '� .'� ' �� V f t w f M k Cer*au of Comykdon } S E-hics Commission Conflict of Interest Law -e nz 4 Y� x has complet d du Conflict- of Interest Law online training program on f I 9/8/2017547 J. " 4l& r Print Cl,s„ cate Win d Certificate http://'www.mapsonIine.net/northandoverma/forms/tablet.htmI.php?id=871488568 After you complete the online ethics portion, you will be able to save your certificate as a pdf file. P163V4V!1l�that file to the "Upload Ethics Certificate"field. SEC � At the end of the Ethics and Online Training Summary and Receipt is a form you may print, sign n4c�t ach to the "Upload Signed Conflict of Interest Acknowledgement:"field. �� i'u j Q} �y V 'r �.4 AtI`, This form autosaves after document uploads to save your work.When you have completed h f ?M*h fAI t re you hit"Submit" Y or"Update"at the end of the form one final time. You may exit the page at that point. If you provided a validOO nail address, you should receive a confirmation email with a link to your record. I am a: 4 Town or School Employee Board/Committee Member Not Listed/Other Town or School? Town Employee School Employee Department: I k I Y a- V -U Employee Name: F ( Employee ID: 610 q q y 8 q Your Email Address: � 5 r, eA,-A C I (in the format email@example.com) Upload Ethics Certificate (Note that the form will automatically save after each upload): Online Ethics Course Completed on: Aeop/eForms pORrH q O �t�ev i6Y ti0 O cn 9 AT ��SSACHIJSE��y TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jbradshawr&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, �pLa-f f i H �pycy- LAi2i{ of the iiryLpU.C2 1400S IW6 4 OT(46P (- Y (Print first and last name) Board or Committee Hereby acknowledge that on `�a ` I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law X Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: i 4, OA1svrr 444q NORTH{ it CD O 1 i SSpCHU$� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01.845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail iradshaw(a&.townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, of the r , f Rl[p>6 :. C L-k 0 C � Oct"fi i i'1`iZ, (Print first and last name) Board or Committee Hereby acknowledge that on � I received a copy of the following documents: Open Meeting Law Guide _ Summary of the Conflict of Interest Law _ Public Records Guide I also have taken the required Oath of Office ad inistered by Joyce A. Bradshaw, Town Clerk on this date. Signature: V �10 R TF/ O`<,,aD 6�416 c 1 � pq c .ac..... • •e �9SSAC HUS���� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshaw(&townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE of the _RppR (Print first and last name) Board or Committee Hereby acknowledge that on �?�' O/y , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law _ Public Records Guide _ Y _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. _ Signature: _0G- NORTiq O -ItLeo r6q�0 �9SSAC14us TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw, CMMC Telephone (978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail ibradshawntownofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE (Print first first and last name) Board or Committee Hereby acknowledge that on ?c t��GP�v /`/, �70/ � I received a copy of the following documents: Open Meeting Law Guide x„ Summary of the Conflict of Interest Law ,x. Public Records Guide X. I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: NORTH OF Stereo ,6q�o 2 5° p. •, a p i ECEtYEQ o TV&g O1 m,'S OFFICE. 2RI17 OCT 10 APB 10• SSACNUSE "'OWN OF NORTH ANDOVER miAS5ACHUSr,""TS TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail iradshaw(a,townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE 1, _ �j�V )D P-iSl , of the CA/, ANC1 gjVE4z- JCt4oUt. opm#4 1 T-T-&-C' (Print first and last name) Board or Committee Hereby acknowledge that on , I received a copy of the 4 fallowing documents: Open Meeting Law Guide Summary of the Conflict of Interest Law X Public Records Guide _ k� I also have taken the required Oath of Office ad inistered by Joyce A. Bradshaw, Town Clerk on this d Signature: 9/11/2017 Certificate • icate Certif of StATMV1 uS Comm Stion mp Co l et i o n . Conflict of Interest Law ' I has completed the Conflict of Interest Law - -_ online training program on J 9/11/2017 A LPr!ntCete http://www.muniprog.eth.state.ma.us/page554968.html 1/1 . '".,�1+ �=,_t��'1., ./��!'�.`1 Yr,{��'".j' ♦�_'S #" Y` °?a`.T.;',��� k,�y"°4�... tf�♦�i"�-r �a.�kr.�� +♦ .�� �.• i�C,��4�+���"f����y�=1�'y°����� (,y���--,4��,�s�t3�:"�r�Y It� Y��f,y A ,�^��Y�f�f���18-�5�'�r'f�f!'�+•� ���''` i yr'"+�,..��,.�h. 6, Ok Cer*ate Comp k on State Ethics Commission y Conflict of Interest Law %66Y q oome ` y Special Education Teacher North Andover Public Schools Town of North Andover has compCeteddw Conf rict of Interest Lar►v online training program on 9/8/2017 ' �.. ..,. . TAMVI "ewe Print Close Certificate Window Certificate Tr t cer*ate of Comykdon State Ethics Commission Conflict of Interest Lawcc - 'Sup . �cG has com Cet d dw Con ict of gnturest"w online training program on 9/8/20 17 t ``yy Print Certificate �x s , Certi ' ate of Comp ktion State Et ics Commission Conflict of Interest Law Kathleen M?'aris 7th Grade Science Teacher NAMS Public School North Andover >r 7 has completed the Conflict of 1rurestl W � /ti t online training program on _ - f =� 9/15/2017 Print RetumtoDataFarm 9/21/2017 Certificate Certti ateeComykdon Statwo 1cs Commission Conflict of Interest Law Betsy Tenenbaum 1 st Grade Franklin School North Andover Public Schools has completed the Conf lkt of 2ntmest"w online training o ram on -� 9/21/2017 ® Retum to Data F http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.html 1/1 Certificate 9/21/17,7:32 AM f�m- 'k G Certificate of Com ceti'on I 5111itto— 5-�Umfmslwfl F t Conflict of Interest La Andrea ` 'ierno ((Dello) Teaching Assistant Franklin School Town of North Andover has commpfeted the Confict of gnterest At�� .. . .haw � online trainin19 yro ram on Al Print I Return to Data Certificate http://www.muniprog.eth.state.ma.us/a001_popups_and_menus_certificate-certificate.htmi Page 1 of 1 YSiW�4Ed�.� W � �"✓ +a g , ,wv ...,......, ...w .. _t 1 Certi ate of Comp k on Stain CS Cam miss on Conflict of Interest Law Weay Trainor ---null--- Franklin North Andover has completed tfie Conff&T of gnterest Law onCine training program on j 9/13/2017 `SSE ,,,�` � .. `ff. '~ Print CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS 1, �.I�a►J 12 U N0L/ who qualified as a member of the (Name) r tv J' N Ursu/� �•. on t�'yy'7 certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) (Name of Public Body) _ /t /z (Date) Pursuant to G.L. c.30A,§20(h), an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body, or their designee. 9/8/2017 Certificate AML y.. m®es.mw y Certificate of State E" ics Commission Co letion Conflict o terest Law CAROL WHELAN has completed the Conflict of ; "�~ : S'`'' f. f. Interest Law online training program on 9/8/2017 1ST�:► ,;� : `i-:fir +' Print Close� Certificate http://www.muniprog.eth.state.ma.us/page554968.htmI 1!1 oil Win-W Certificate of Completion C011fliet of Interest Law darlene wallis to town of north andover ecc has completed the Conflict of Interest Law online training program an 9%14l2017 si �ci uuca[e hnp://wwwmuniprog.eth.state.ma.us/page554968.litiiii Fill Certificate of colt ptetion r Sum s Comm scion J Conflict of Interest Law 3 warp �et�jerbp Noon Attendant North Andover Public Schools h Essex 05 roniPteteb Me Couflirt of liiteregt Iatu online training progrant on �S 7/31/2017 x ti Printr-Close Certificate Window Certificate t 7/31/17,2:25 PM f'7 utificate http://www.muniprog.eth.state.ma.us/page554968 html .d" Idds Air" s , r 4 Certificate of Comptetion State s Commission Conflict of Interest Law � �a�rp �et�jer�ip F Noon Attendant North Andover Public Schools Essex 1)a5 completeb tl)e Conflict of ,Interest Rate online trafrtittgrogrant on 7/31/2017 4 Orr PrintClose Cenfficate Win ow 1 Certificate of 1 7/31/17, 225 PM �enmcate Page 1 of i MWw Certif icate of S tate es Commssion Co letion rn p Conf lict o Interest Law Andrea Wynn Teaching Assistant North Andover Public Schools North Andover has completed the Conflict of ' S'r'; Interest Law s online trainin Frogram on 9/10, 7 't- S 4t Printicale Window C http://www.muniprog.eth.state.ma.us/page554968.html 9/10/2017 TOWN OF NORTH ANDOVER I �� VOLUNTEER SERVICE AGREEMENT I enter into this Agreement to volunteer uncompensated services to my Town and acknowledge that: I am (check one): Over 18 years of age Under 18 years of age(Parent/Guardian Consent Required) 1 know of no reason, medical or otherwise, which would prevent me from performing the required tasks; and that I have the necessary skill and ability to perform them. I hereby assume full responsibility for my own safety. Except where resulting from the negligence of the Town or its employees, I will hold the Town harmless from any injury to me or damage to my property and from injury or damage resulting from my own negligence. I will perform the volunteer service in compliance with the direction of Town Officials. 3 -3 ar Committee/Department Approval Date Volunteer Signat re Date Signature I give consent for my child to volunteer for the Town of North Andover. Parent/Guardian Signature Date Volunteer Contact InfformDation Emergency Contact Information _- Name Name /01-3 Street Address Street Address , City, State,Zip Code City, State,Zip Code Home Phone Number Home Phone Number - 63 /--2 0 Cell Phone Number Cell Phone Number Business/Other Phone Number Business/Other Phone Number O tpORTM 1" S11.E D 16 32 e. .6 OL O A �.9 DA1TfD I.PP'�,�5 SSACNUSe TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail jradshaw(ii�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE G' of the C_U (Print first and last name) Board or Committee Hereby acknowledge that on , I received a copy of the following documents: Open Meeting Law Guide Summary of the Conflict of Interest Law Public Records Guide I also have taken e required of Of y J y A. radsha own Clerk on this date. Signatu CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS I, !Jxt-� W:Q.V1W,&('1 who qualified as a member of the (Name) Z-, ,v� &6m-d Cs ZF-OZ.1 on fD 6c-t d�l�] certify pursuant (Public Body) (Date) to G.L. c. 30A, § 20(h) and 940 CMR 29.04,that I have received and reviewed copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c.30A, §§ 18-25; 2) the Attorney General's Regulations,940 CMR 29.00-29.11; 3) the Attorney General's Open Meeting Law Guide, explaining the Open Meeting Law and its application; and 4) if applicable,a copy of each Open Meeting Law determination issued by the Attorney General within the last five (5)years to the public body of which I am a member and in which the Attorney General found a violation of the Open Meeting Law. I have read and understand the requirements of the Open Meeting Law and the consequences of violating it. I further understand that the materials I have received may be revised or updated from time to time, and that I have a continuing obligation to implement any changes to the Open Meeting Law during my term of office. (Name) 2�v1 6 c'-d o(- e -S Name of Public Body) jo cacf (�--11 (Date) Pursuant to G.L. c.30A,§20(h),an executed copy of this certificate shall be retained, according to the relevant records retention schedule, by the appointing authority,city or town clerk, or the executive director or other appropriate administrator of a state or regional body,or their designee. i tAORTH VLID /6 - O A • 1. ATED ��SSACHUs��t� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone.(978) 688-9502 Town Clerk Fax (978) 688-9557 E-mail jradshaw(i�townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, l Vr4_rlt,4A� 0E I titRC I C H , of the,Zo 64k-b 6 F PPS la S (Print first and last name) Board or Committee Hereby acknowledge that on /d Oct a,o i_7 , I received a copy of the following documents: Open Meeting Law Guide X Summary of the Conflict of Interest Law __ Public Records Guide X _ I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. Signature: ;, __ p10RTF► q / v �O FO A Argo �9SSACH�1`����� TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978) 688-9502 Town Clerk Fax (978)688-9557 E-mail _ibradshawna townofnorthandover.com ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND OATH OF OFFICE I, Ijz)1_61E Ll"1.41V5 , of the 14SP V1, ( c IL, (Print first and last name) Board or Committee Hereby acknowledge that on Sr_ i°1Y k4 j y 2617 , I received a copy of the following documents: I r Open Meeting Law Guide _ Summary of the Conflict of Interest Law _ Public Records Guide I also have taken the required Oath of Office administered by Joyce A. Bradshaw, Town Clerk on this date. d 1'14&111 Signature: 12/12/2017 Certificate t Certf f frame of Completton t State Ethics Commission Conflict of Interest Law �"atte �uEgt�dltt� Tile 1 Aide North Andover Public Schools North Andover bad completeb the Conflict of Nteregt Lam online training program on y + 12/12/2017 Print certfmcate http://www.mu ni prog.eth.state.ma.us/a001_popups_and_menus_certificate_certificate.htmi 9/13/2017 Certificate Certtf rate of Completion Sum cs COm tsian Conflict of Interest Law 36eb Zagarri } Admin Assistant i School Department North Andover bag completeb the Conflict of Rtereot XaW � online training program on 9/13/2017 Print Return to Data Form G@tffficBU http://"".muniprog.eth-state.ma.us/a001_popups_and_menus_certificate_certificate.htmI 1/1