2017  Disclosure of Information for Professional Service Provider to Hollidaysburg Borough's  Municipal Pension System  Professional Service Provider: Select Financial Group  Act 44 of 2009 requires annual disclosure of certain information by individuals or entities that hold contracts with and provide professional services to a municipal pension system. Please complete and return this disclosure to the department as soon as possible. If you feel you are not obligated to complete the  disclosure, please provide written explanation. Responses should be directed to:  Mr. James Gehret Borough Manager Hollidaysburg Borough 401 Blair Street Hollidaysburg, PA 16648  Section 1-1 Definitions:  The following terms are defined within Section 701-A of Act 44 of2009.  Affiliated. Entity: Any oft the following:  1. A subsidiary or holding company of al lobbying firm or other business entity owned 2. An organization recognized by the Internal Revenue Service as a tax-exempt organization under section 501(c) of the Internal Revenue Code of 1986 (Public Law 99-514, 26 U.S.C. $ 501(c)) established by a lobbyist or lobbying firm or an A person or an affiliated entity that has aj professional services contract with a  in whole or inj part by al lobbying firm;  affiliated entity. municipal pension system the Pennsylvania Election Code.  Contractor:  Contributions: As defined in section 1621 of the act of June 3, 1927 (P.L. 1333, No. 320), known as  Executive Level Employee:  An employee of aj person or the person's affiliated entity who: municipality or a municipal pension system; or municipality or a municipal pension system.  1.C Can affect or influence the outcome of the person's or affiliated entity's actions, policies or decisions relating to pensions and the conduct of business witha 2.Is directlyinvolved in the implementation or development of policies relating to pensions, investments, contracts or procurement or to the conduct of business with a As defined in section 1621 oft the act of June 3, 1937 (P.L. 1333, No. 320), known as  Political Committee: Professional  the Pennsylvania Election Code.  Services Contract: A contract to which the municipal pension system is a party that is:  1.Fort the purchase or provision of professional services, including investment services, legal services, real estate services and other consulting services; and 2. not subject to a requirement that the lowest bid is accepted.  Page I of4    2017  Disclosure of Information for Professional Service Provider to Hollidaysburg Borough's  Municipal Pension System  Professional Service Provider: Select Financial Group  Section 2-N Municipal Officials: you complete the disclosure.  The following individuals are identified as pension system officials and employees to be considered as  Elected Officials John Stultz Mayor  Joseph Pompa Borough Council President Joe Dodson Borough Council Vice-President Stephanie Wertz - Council Member Mark Shawley- Council Member Jeffery Kentner. - Council Member Sean Burke - Council Member Patrick Plummer - Council Member Donna Carson Tax Collector Appointed Officials or Employees Police Pension Committee Member Pension Committee(s)  James E. Gehret Borough Manager/Finance Dircor/CA0.Nom.Uaiom Plan/CAO, Police Plan,  Mark Lingafelt - Police Officer, Police Pension Committee Member  Page 2 of4    Section 3-1 Individuals Providing Professional Services and Affiliated Entities: A. Please provide names and titles of all individuals who provide professional services to the  municipal pension plan.  John P. Abriola-1 Managing Partner, Investment Advisor K.. Jeffrey Hanna - Investment Advisor Diana E. Abriola - Investment Advisor Beverly A. Ross - Administrative Assistant Cynthia A. Mohler- - Administrative Assistant  B. Please identify any Affiliated Entity (name and title) of your company.  United Capital  Page 3 of4    2017  Disclosure ofInformation for Professional Service Provider to Hollidaysburg  Borough's Municipal Pension System Professional Service Provider: Select Financial Group  Section 4-1 Disclosure:  Regarding individuals who will provide services under the contract: 1. Are any current or former officials or employees of the municipality? 2. Are any a registered federal or state lobbyist? 3. Have any made a contribution in the past two years to a municipal official or candidate for office at municipality? Regarding: your firm and Affiliated Entities:  Yes No X X X Yes No  1. Have you or an Affiliated Entity made any contributions to which all of the following  apply:  a. The contribution was made within the last five years. b. The contribution was made by an officer, director, Executive-Level employee or owner of atl least 5% of the firm or Affiliated Entity. C. The amount of the contribution was at least $500 in the form of : asingle contribution by a person in subparagraph (b) above; or ii. the aggregate of all contributions by all persons in subparagraph (b) above. .acandidate for any public office in the Commonwealth or to an ii.a political committee of a candidate for public office in the Commonwealth or of an individual who holds that office.  X  d. The contribution was made to:  individual who holds that office; or  2. Have you or an Affiliated Entity given any gifts to an official or employee of the municipal pension system or the municipality which controls the municipal pension 3. Do you or an Affiliated Entity employ or retain any third-party intermediary, agent or 4. a. Do you or an Affiliated Entity have a direct financial, commercial or business relationship with any official of the municipal pension system or the municipality Has the municipal pension system consented in writing to the relationship following 5. Do any additional potential or actual conflicts ofi interest exist relative to contracting  X X X  system?  lobbyist? IF"Yes".deseribe the duties oft that person. which controls the municipal pension system? b.A Answer only ift the answer to 4a. was "Yes":  full disclosure?  X  ofs services with the municipality? (attach additional pages if necessary): Name and address oft the contributor: Contributor'sr relationship to the Contractor: Amount of the contribution: Date oft the contribution:  6. For the contribution(s) disclosed in your answer to No. 1 above, provide the following information:  Name and office or position of each person receiving a contribution:  We understand that knowingly making a material misstatement or omission on this form may cause the  municipal,p@nsion system to void our professional services contract.  /I-29-17 Date  E  Page 40 of4