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HomeMy WebLinkAboutProgressive Commercial Aquatics, Inc.CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person committs an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which an activity described in Section 176.006(a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3. Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. El Glenn Brown, City Manager El Terry Childers, Deputy City Mgr ❑ Kathy Merrill, Asst. City Mgr. El Robert Alley, Fire Chief El Steve Beachy, Parks & Rec El Olivia Burnside, Inf. Tech. El Pete Caler, Landfill Mgr. El Harvey Cargill, City Attorney El Michael Clancey, Police Chief ❑ David Gwin, Economic Dev. El Connie Hooks, City Secretary El Jeff Kersten, Chief Fin.Officer El David Massey, Electric 0 Becky Nugent, Public Relations El Julie O'Connell, Human Resources El Lance Simms, Planning & Dev 0 Mark Smith, Public Works El Ed Spillane, Municipal Judge El Cheryl Turney, Purchasing Mgr. El John Woody, W/WW 1,J2KNONE Describe each affiliation or business relationship with an employee checked in Question 3 above: 4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local government entity that is the subject of this questionnaire. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 ❑ Lynn Mcllhaney, Place 4 1....12- NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Katherine Edwards ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate NONE ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson -NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart O Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering ❑ Rusleen Maurice ❑ Reba Ragdale ❑ 1..2 --NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford Cl Harry Green Planning and Zoning Commission ❑ John Nichols, Chair ❑ Glenn Schroeder ❑ Marsha Sanford ❑ Dennis Christiansen ❑ Harold Strong 1.NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heaney 0 Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King ❑ Ward Wells ❑ John Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate L.'NONE ❑ Jay Goss, Chair ❑ Denise Whisenant NONE Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland ZONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Mariott „NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford J'NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka ,NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Area 11 ❑ Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate, Area IV ❑ Douglas Rape', ETJ Resident ❑ Mike Guido, Alternate, Resident -At -Large ❑ Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate ❑ Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ James Massey, Intergovernmental Comm/TAMU Admin ❑ Dr. Clark Ealy, Intergovernmental Comm/CSISD ❑ Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership ❑ Linda LaSut, Intergovernmental Comm/MPO ❑ Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce ❑ Rodney Weis, Intergovernmental Comm/TAMU Transit ❑ Dr. Colleen Netterville, Intergovernmental Conun/BISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District 0 Chad Bohne, Intergovernmental Cormn/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG 0 Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Conon/ Easterwood Airport �- NONE The following individuals are appointed by the City Council to represent the City of College Station on joint committees with other governmental agencies and community groups. Brazos County Health Department ❑ Lynn Mcllhaney ❑ Ben White NONE Brazos Valley Council of Governments ❑ Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor j2 -NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Lynn Mcllhaney NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑ Chris Scotti BONE r City Center Committee ❑ Ron Silvia ❑ Ben White ❑ Dave Ruesink NONE / Intergovernmental Committee ❑ Ron Gay ❑ Ben White ❑ John Happ ,-NONE ❑ Dave Ruesink -NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink ONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Lynn Mcllhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT NONE ❑ Ron Gay O John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford 0 Sharon Colson ❑ Marc Chaloupka ❑ Jodi Warner ONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or other relationship. Attach additional pages to this Form CIQ as necessary. 5. Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, B, or C is YES. A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? Yes No C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each affiliation or business relationship. 6. p �f nature of person doing business with the governmental tity 9—c Date Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person committs an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1. Name of person doing business with local governmental entity. pp 1ralTeSS/1....-e- 2. OFFICE USE ONLY Date Received Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which an activity described in Section 176.006(a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3. Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. ❑ Robert Alley, Fire Chief ❑ Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ John Woody, Utilities Michael Clancey, Police Chief Joey Dunn, Planning & Dev Don Fazzino, Legislative Liason Charles Wood, Economic Dev Connie Hooks, City Secretary Jeff Kersten, Finance NONE ❑ Charles McLemore, Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. Describe each affiliation or business relationship with an employee checked in Question 3 above: /t/ /1 4 4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local government entity that is the subject of this questionnaire. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 0 John Happ, Place 2 ❑ Susan Lancaster, Place 4 ❑ Chris Scotti, Place 5 H -NONE City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Larry Ringer, Chairman ❑ Katherine Edwards 0 Don Scherr ❑ Eric Miller ❑ Jeanne Mitchell ❑ Jo Berg ❑ Lois Koontz 0 James Bradford O. -NONE Cemetery Committee ❑ Sarah Adams, Chair 0 Virginia Reese ❑ James Batenhorst ❑ Mary Lind Bryan ❑ David Chester 'NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Kevin Myers ❑ Joe Wallace ❑ Dan B. Sears, Chairman ❑ George McLean, Vice Chair ❑ Frank Cox ❑ Mike Lane ❑ Larry D. Patton ❑ David Hart, alternate ❑ Steve Parker, alternate ❑ David Ruesink, alternate 1.12KNONE ❑ Karen Kasper, Merchant ❑ Joey Dunn, Dir. Planning & Dev ,I�NONE Facade Improvement Program Advisory Committee ❑ Valerian Miranda, Architect ❑ Rick Lemmons, Business Owner 0 Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator Historic Preservation Committee ❑ Hillary Jessup, Chairman El Bill Lancaster El Marguerite Anthony ❑ David Ruesink ❑ Thomas Taylor ❑ Ernie Wright ❑ Colleen Risinger 1,12rNONE O Rebecca Eplen ❑ Rusleen Maurice j2ri\TONE O Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton NONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board El Glenn Schroeder El Jeannie McCandless ❑ Harry Green Planning and Zoning Commission O Scott Shafer, Chairman El John Nichols ❑ Marsha Sanford 0 Dennis Christiansen E l Harold Strong vErIVONE Design Review Board ❑ Marsha Crenwelge O Dipankar Sen El Neal Nutall, Jr. ❑ Mary Sherwood O Peggy Samson ❑ Jodi Warner El Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds El Bill Davis ❑ Rick Heany El Hunter Goodwin El Nancy Sawtelle E l Alan King ❑ Ward Wells ❑ Scott Shafer El Susie Cox, alternate ❑ Robert Rayburn, alternate ZONE Zoning Board of Adjustments ❑ Jay Goss, Chair El Joshua Benn 0 John Richards El Graham Sheffy El Donald Braune 0 Charles Taylor El Denise Whisenant El Derek Dictson t7NONE Research Valley Partnership Board of Directors ❑ David Hickson ❑ Larry Mariott ❑ Glenn Brown, City Manager 1.NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair ❑ Marc Chaloupka ❑ James Massey r8'�NONE The following individuals are appointed by the City Council to represent the City of College Station on joint committees with other governmental agencies and community groups. Brazos County Health Department O Susan Lancaster ❑ Nancy Berry ,NONE Brazos Valley Council of Governments Board of Directors O Ron Silvia, Mayor vi2vNONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor ,,B NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Susan Lancaster NONE BVSWMA Policy Advisory Board 0 Ron Silvia, Mayor ❑ Susan Lancaster /NONE ❑ Ron Silvia I oNE ❑ Nancy Berry HONE ❑ Nancy Berry t,17'NONE City Center Committee ❑ Ben White Cl Nancy Berry Intergovernmental Committee ❑ Ben White ❑ John Happ Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Ron Gay ONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Bryan Woods, TxDOT „ 1 ONE ❑ Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee ❑ Ron Gay 0 Chris Scotti NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or other relationship. Attach additional pages to this Form CIQ as necessary. 5. Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, B, or C is YES. 4/A A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? Al/pf- Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? Yes No C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? A Yes No D. Describe each affiliation or business relationship. 4A- 6. Signature of person doing business with the governmental entity - 06 Date Adopted 01/13/06