. 0F LOUISVILLE BOARD OF TRUSTEES CONFLICT OF STATEMENT Year 7/1/2015 - 6/30/2016 Organization UNIVERSETY OF Name of Individual {?hifbiqe Vi Gm 103 2 Business Transaction wi UofL 1. Other than an employment relationship, do you or a family member conduct business with the UofL? Business transactions include, but are not iimited to contracts of saie, lease, iicense and performance of services, whether initiated during the UofL tax year or ongoing from a prior year. Business transactions also include joint ventures in which either the profits or capital interest of the UofL and of the interested person exceeds 10%. if "Yes," describe your business transaction(s) with the UofL: 2. Do you or a family member own 35% of an entity (C-corporation, S?corporation, Partnership, LLC or other entity type(s), directiy or indirectiy, that conducts business with the UofL? - if ?Yes,? describe your business transaction(s) with the UofL: Page 1 of 4 on an 3. Do you or a family member, in combination with other ‘interested person(s)” own 35% of an entity (C-corporation, S-corporation, Partnership, LLC or other entity type), directly or indirectly, that conducts business with the UofL? • 4. Do you or a family member, serve as an officer, director, trustee, or key employee or an entity that does business with the UofL? • 5. If “Yes,” describe your business transaction(s) with the UofL: If “Yes,” describe your business transaction(s) with the UofL: Do you or a family member serve as a partner, member, or shareholder of an entity (with ownership interest in excess of 5% of a partnership or professional corporation) that conducts business with the UofL? • If “Yes,” describe your business transaction(s) with the UofL: Page Zof4 Q ~ 6. Did a family member receive a compensation payment in excess of $10,000 from the UofL? . lf "Yes,? explainfamily member receive grants or other assistance, including provision of goods, services, or use of facilities from the Uoft? Grants include scholarships, fellowships, internships, prizes, and awards. . if "Yes,? explain: N0 8. Do you have 35% control in an entity that received grants or other assistance, including provision CI of goods, services, or use of facilities from the Uoft? If ?Yes," explain: NO 9. Do you have any loans to or from the UofL? if "Yes,? expiain. NO 10. Are you aware of any excess benefit transactions to report? An excess benefit transaction is where the Uofi. directiy or indirectly provided an economic benefit where the value of the benefit exceeds the value of the consideration received by the UofL. Page 3 of4 0 If "Yes," explain; Business and Family Relationships with interested Persons 11. Do you have a family or business reiationship with any other officer, director, trustee, or key empioyee of the UofL? Yes For each family and business reiationship, identify the persons and indicate family or business relationship. 7417/) LAC th?g?gk gall?Wed +0 545w: 593;?) I Ci?w? Gfec? (Mao! 6km mg?l?ba?r?? [prow?ole CeV-l-ag?m ?es/$1263 +13 We etc/24:47! (ii/104 W694 amx/ ?209 Ez'nemm (me/74w? 6/ gay/2am) @(63 (calm/v7 {Jul-W at much lay/56V 63/50)? a? j/zdiw?o/oa/S) Page 4 0M Beamer,Jake From: Sent: To: Subject: Beamer,Jake Thursday, March 10, 2016 5:16 PM 'Steve Campbell' RE: BOT Conflict of Interest Forms 2015-16 Thanks, Steve.  I'll amend the form for the current year, strikethrough the Wilson reference and include this email  showing the reasoning behind it.    Best,     Jake    ‐‐‐‐‐Original Message‐‐‐‐‐  From: Steve Campbell [mailto:campbell.steve89@gmail.com]   Sent: Thursday, March 10, 2016 5:14 PM  To: jake.beamer@louisville.edu  Subject: Re: BOT Conflict of Interest Forms 2015‐16    Jake,    Nothing has changed since the last conflict form other than the reference to Steve Wilson in question 11 can be  removed since he is no longer a trustee.      Please let me know what I need to do.    Many thanks.    Regards,    Steve  > On Mar 10, 2016, at 5:09 PM, jake.beamer@louisville.edu wrote:  >   >     1