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HomeMy WebLinkAboutBrazos PavingCONFLICT OF INTEREST QUE'TIONNAIRE For vendor or other person doing busine s with local governmental entity FORM CIQ OFFICE USE ONLY This questionnaire is being filed in accorda ce with chapter 176 of the Local Government Code by a person doing busin...s with the governmental entity. By law this questionnaire must be filed wit the records administrator of the local government not later than the 7th busi ess 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 iolates Section 176.006, Local Government Code. An offense under this se tion is a Class C misdemeanor. Date Received 1. Name of person doing business with lo al governmental entity. 2. Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated comp eted 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 reel_-____ _. 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 ❑ Pete Caler, Landfill Mgr. ❑ David Gwin, Economic Dev. ❑ David Massey, Electric ❑ Lance Simms, Planning & Dev Cl Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Coinie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Olivia Burnside, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ Ed Spillane, Municipal Judge xi NONE 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 ollege Station Elected Officials C II lege Station City Council ❑ B.n White, Place I ❑ L nn Mcllhaney, Place 4 TAN NE 0 ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Stat on Committees, Boards, and Commissions CS Library Committee ❑ Larry Ringer, Chairman ❑ K. herine Edwards 0 Don Scherr ❑ Mary Fran Troy ❑ Je nne Mitchell 0 B. Carroll Johnson O Sonio Margarita Gangotena ❑ Ja es Bradford ial NONE ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester O Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate ►2 NONE ❑ Vi ❑ W 0 11 N 0 I Cemetery Committee ginia Reese 0 Kevin Myers ]don Kruger 0 Joe Wallace Slocum ❑ James Matson NE onstruction Board of Adjustments and App alsBuilding & Standards Commission ❑ Fr. k Cox ❑ David Hart ❑ L. D. Patton ❑ Charles Thomas, alternate O GI nn Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright '133 NONE ❑ Tedi Ellison ❑ Rusleen Maurice 12} NONE O Jodi Warner, Chair ❑ Shawn Rhodes O John Crompton PI NONE ❑ John Nichols, Chair O Marsha Sanford ❑ Harold Strong ❑ Rick Heaney ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant O NONE Hist s ric Preservation Committee ❑ Bi 1 Lancaster ❑ Ja e Hughey ❑ N.al Nutall, Jr. Jo nt Relief Funding Review Committee ❑ J. ❑ R ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger evin Byrne ❑ Deborah Deitering a Ragdale 0 Pa ks and Recreation Board ❑ K. hleen Ireland 0 Joan Perry ❑ Jo y Ford 0 Gary Thomas ❑ H. Green ❑ Gary Erwin Planning and Zoning Commission ❑ GI; nn Schroeder ❑ Derek Dictson ❑ De nis Christiansen ❑ Bill Davis ❑ NONE Design Review Board ❑ Hu ter Goodwin 0 Nancy Sawtelle ❑ W.rd Wells ❑ John Nichols ❑ Ro ert Rayburn, alternate NONE Zon ng Board of Adjustments ❑ Jos ua Benn ❑ Do ald 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 ® NONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area Ill ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Re.earch Valley Partnership Board of Directors ❑ L • ry Mariott NONE If Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ Ja es Massey Outs de Agency Funding Review ❑ Ch rles Taylor O Sh ryl Welford ®N NE N i rthgate Tax Increment Finance Board O Da id Scarmardo O GI nn Thomas Com i rehensive Plan Committee ❑ Joh Richards, Area I O Bri n Bochner, Area II ❑ La ie Corbelli, Area III ❑ Jer , Cooper, Area IV O Kri'tina Campbell, Alternate, Stu'ent Resident ❑ Cra g Hall, Resident -At -Large ❑ Lyn Mcllhaney, Alternate, Co ncilmember ❑ G • Erwin, Parks & Rec ❑ La , Haskins, Northgate Dist ict Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka lS1 NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson Cl Dale O'Reiley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Area 11 ❑ Tom Taylor, Alternate, Area IlI ❑ Adrian Williams, Alternate. Area iv ❑ Douglas Rape', ETJ Resident ❑ Mike Guido, Alternate, Resident -At -Large ❑ Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate El Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. O Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ James Massey, Intergovernmental Comm/TAMU Admin ❑ Li da LaSut, Intergovernmental C m/MPO ❑ Li dsey Guindi, Intergovernmental Co m/Chamber of Commerce ❑ R•dney Weis, Intergovernmental Co m/TAMU Transit ❑ Dr. Clark Ealy, Intergovernmental ❑ Dr Comm/CSISD In ❑ Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership ❑ M In Br Colleen Netterville, rgovernmental Comm/BISD rgie Lucas, rgovernmental Comm/ os Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport ® NONE The following individuals are appointed ' y the City Council to represent the City of College Station on joint committees with other governmenta agencies and community groups. ❑ Lynn Mcllhaney ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Lynn Mcllhaney ❑ Ron Silvia, Mayor ❑ Ron Silvia • NONE ❑ Ron Gay 21 NONE Brazos County Health Department ❑ Be White ® NONE N razos Valley Council of Governments NE B/ 1 S Metropolitan Planning Organization • N Ii NE BV 1 OG TMPA Regional Park ' roject Advisory Board • NINE B ' SWMA Policy Advisory Board ❑ Ch is Scotti ity Center Committee ❑ Be White Inte governmental Committee ❑ Be White •Lil NONE ❑ Dave Ruesink ❑ John Happ ❑ Dave Ruesink IE1 NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink NONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Lynn McIlhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT p NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford ❑ Sharon Colson ❑ Marc Chaloupka ❑ Jodi Warner 51) NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: NO.'"NC_ 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. Signature person doing business with the governmental entity 6A/0 7 Date Adopted 01/13/06