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HomeMy WebLinkAboutAshlock's NurseryCONFLICT OF INTEREST QUESTIONNAIRE 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. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 2. A\ock 'S Ivvrsef-. 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. ❑ Glenn Brown, City Manager ❑ Robert Alley, Fire Chief El Pete Caler, Landfill Mgr. ❑ David Gwin, Economic Dev. El David Massey, Electric ❑ Lance Simms, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary ❑ Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. El Olivia Burnside, Inf. Tech. E l Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Com}ell, Human Resources ❑ Fd Spillane, Municipal Judge NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: No" 4. Describe each affiliation or business relationship with a person who is a local gov+rnment officer and who appoints or employs a local government officer of the local government entity that is the subject of this questionnaire. City of College Station Elected Officials College Station City Council ❑ Ron Silvia, Mayor 0 Ben White, Place 1 O Ron Gay, Place 3 0 Lyrin Mcllhaney, Place 4 ❑ David Ruesink, Place 6 ��''NONE ❑ John Ham, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune O Dan B. Sears, Chairman ❑ Mike Lane uI❑ eve Parker, alternate Ed' NONE B/CS Library Committee ❑ Katherine Edwards 0 Don Scherr ❑ Jeanne Mitchell ❑ B.9rroll Johnson O James Bradford ONE Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC'locum ONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson O David Hart O Charles Thornas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe CIie Wright 1412z ONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Margueritje Anthony ❑ Meredith ' Valler ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering O Rusleen Maurice 0 Reba Ragdale ❑ GVINONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ hn Crompton NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ John Nichols, Chair ❑ Glenn Schroeder ❑ Marsha Sanford ❑ D is Christiansen ❑ Harold Strong D/NONE ❑ Rick Heaney ❑ Alan King O Susie Cox, alternate ❑ Jay Goss, Chair ❑ enise Whisenant NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek DictsOn ❑ Bill Davis ❑ Hunter Goodwin ❑ Nancy SawteIlle ❑ Ward Wells ❑ Joh icholsli ❑ Robert Rayburn, alternate ai<ONE 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 O Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair O To i Kirkland ONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II O Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation D Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ llLarry Mariott ONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ S ryl Welford NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II Cl 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 0w2arc Chalbupka ONE II ❑ Roger Ree4e ❑ Carolyn Belrrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area 11 ❑ Tom Taylor,IAlternate, Area III CIAdrian Williams, Alternate, Area IV ❑ Douglas Rape', ETJ Resident ❑ Mike Guido, (Alternate, Resident -At -Large O 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 Comm/BISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental CommTINDOT ❑ Michael Parks, Intergovernmental CommBVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Testdn, Intergovernmental Co Ea4terwood Airport ONE 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 Ilhane ❑ Ben White ZONE ❑ Lynn Mc y Brazos Valley Council of Governments O Ron Silvia, Mayor NE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor SZNIcINIE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney N'116NE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris ScottiO/NE ❑ Ro)Silvia 'I ONE ❑ Ron Gay glA(ONE City Center Committee ❑ Ben White Intergovernmental Committee ❑ Dave Ruesintic ❑ Ben White 0 John Happ ❑ D e Ruesink ONE O Dave Ruesink ❑ Ron Gay O Ken Fogle O Michael Parker, BVCOG ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Ha Sister Cities Association ONE Transportation Committee ❑ John Happ ❑ Linda LaSuit, MPO El Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford ❑ Sharon Colson P El Lynn Mc�Ilhaney ❑ Dennis Christianson, TTI g)tolv--; ❑ Marc Chaloupka ❑ Jour Warner ONE Describe each affiliation or business relationship with an employee checked in Question 4 above: \,0e 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 lobal governmental entity? Yes No C. Is the filer of this questionnaire affiliated with a corporation or other business entity thitt 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. c&A, :\j, k4110 Signature of person doing business with the governmental entity -S `G7 Date Adopted 01/13/06