HomeMy WebLinkAbout14- Kukulski 10-18-14 Gift Disclosure Form t°F suzE.
z
U(
Submit by Email Print Form
City of Bozeman
P.O.Box 1230/121 North Rouse Avenue
Bozeman,Montana
agenda@bozeman.net
59771
Phone:406-582-2320
Gift Disclosure Form Fax:406-582-2344
www.bozeman.neeman.net
Date: 10/18/2014
Name: Chris Kukulski
Department: Admin.-CM
Phone#: 406-582-2306
Email address: ckukulski@bozeman.net
Who gave the item? President Cruzado-Montana State University
For what purpose? ; W� Qao-�M 'YA eJ
Describe the Item: Two football tickets to home Football game(copy attached)
What is the Items Estimated Value?
Have you reviewed the Gift Provision on page 10 of the City of Bozeman Ethics
Handbook to verify this is an item you can receive? Drop-down List
Comments:
By submitting this form,you are confirming that the information contained herein is correct and true to the best of your
knowledge. A digital signature can be created through the'submit e-mail' utton. f you p of r,you can also print,sign
and mail or deliver to the clerk's office. Thank you! �J
Signature:
If you have questions about the gift provision please call or e-mail the City Attorney at(406)582-2309.
Hilton
�, Hilton7 lnr Garden lnyr
Garden Bozeman
Bozeman IIIIIIIIIIIII VIII IIIIII VIII IIIIIIIIII
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII „96329121294691
3414
c->
aNO z H.YiA wIW-I�-..� f. v
YO
tia LOW.
1- FSG[ F WQ� JVi NC7¢N y^ V�J
Waco Wy W0O aa]Cp -
Nl^O¢Ny.- W
U
¢
m �.+ C •---� N d Y
d GU W ca d � ~ ^•� w
�G N ,"i la • �L
O•^ CC � � U Q_ ¢N
j -F+
%M WN
JW
Wy~� JN
�y MSUMICB AS AdultSuite
MSUMICB A
PRICE$30.43 CONV FEE
$0.00 v
S Adult Suite
PRICE$30,43 CONY FEE$0.00
m c � oco a N
QtiN
O0 WWJ~WU�W N Wim---6
Lu W�WOO Ia�CC W
W