HomeMy WebLinkAboutAmerican Wire GroupCONFLICT 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.
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OFFICE USE ONLY
Date Received
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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
❑ Pete Caler, Landfill Mgr.
El 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.
❑ Olivia Burnside, Inf. Tech.
❑ Michael Clancey, Police Chief
❑ Jeff Kersten, Chief Fin.Officer
❑ Julie O'Connell, Human Resources
❑ Ed Spillane, Municipal Judge
i NONE
Describe each affiliation or business relationship with an employee checked in Question 3 above:
AMERICAN WIRE GROUP
A POWERFUL SOLUTION
1920 E. Hallandale Beach Blvd.
Sulu PH8
liallandak Florida 33009
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.
City of College Station Elected Officials
College Station City Council
❑ Ron Silvia, Mayor ❑ Ben White, Place 1
❑ Ron Gay, Place 3 ❑ Lynn McIlhaney, Place 4
O David Ruesink, Place 6 NONE
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
City of College Station Committees, Boards, and Commissions
O Larry Ringer, Chairman
❑ Mary Fran Troy
❑ Sonio Margarita Gangotena
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
❑ Donald Braune
❑ Dan B. Sears, Chairman
❑ Mike Lane
O Steve Parker, alternate
yr NONE
B/CS Library Committee
❑ Katherine Edwards
❑ 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
g NONE
❑ Kevin Myers
❑ Joe Wallace
❑ James Matson
❑ David Hart
❑ Charles Thomas, alternate
❑ Quinn Williams
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1920 E. Hallandale Beach Bivct.
Suite PH8
Hallandale, Florida 33009
❑ Hillary Jessup, Chairman
❑ Haskell Monroe
❑ Ernie Wright
, NONE
❑ Tedi Ellison
❑ Rusleen Maurice
NONE
❑ Jodi Warner, Chair
❑ Shawn Rhodes
❑ John Crompton
NONE
❑ John Nichols, Chair
❑ Marsha Sanford
❑ Harold Strong
❑ Rick Heaney
❑ Alan King
❑ Susie Cox, alternate
❑ Jay Goss, Chair
❑ Denise Whisenant
NONE
Historic Preservation Committee
❑ Bill Lancaster
❑ Jane Hughey
❑ Neal Nutall, Jr.
Joint Relief Funding Review
Committee
❑ J. Kevin Byrne
El Reba Ragdale
Parks and Recreation Board
❑ Kathleen Ireland
O Jody Ford
❑ Harry Green
Planning and Zoning
Commission
❑ Glenn Schroeder
❑ Dennis Christiansen
NONE
Design Review Board
❑ Hunter Goodwin
❑ Ward Wells
❑ Robert Rayburn, alternate
Zoning Board of Adjustments
❑ Joshua Benn
O Donald Braune
❑ Marguerite Anthony
❑ Meredith Waller
❑ Colleen Risinger
❑ Deborah Deitering
❑ Joan Perry
❑ Gary Thomas
❑ Gary Erwin
❑ Derek Dictson
El Bill Davis
❑ Nancy Sawtelle
❑ John Nichols
"jNONE
❑ John Richards
❑ Thomas Mather
AWG
AMERoICANWIRE GROUP
UL SOLUTION
1920 E. Hallandale Beach Blvd.
Suite PH8
f{allandaie, Florida 33009
❑ Larry Hodges
O Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
❑ Don Lewis
El Gregg Baird
El Chad Jones
❑ Stephen Syptak, Chair
❑ Tom Kirkland
NONE
❑ 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
O Lloyd Wasserman, County
Commission
Research Valley Partnership
Board of Directors
❑ Larry Mariott
fk NONE
Wolf Pen Creek TIF Board
❑ Marsha Sanford, Vice Chair
El James Massey
Outside Agency Funding Review
❑ Charles Taylor
El Sheryl Welford
19 NONE
Northgate Tax Increment
Finance Board
El 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
El Gary Erwin, Parks & Rec
El Larry Haskins, Northgate
District Assoc.
O Chris Scotti, Councilman
❑ Marc Chaloupka
NONE
❑ Roger Reese
❑ Carolyn Berrow
❑ Anne Jackson
❑ Dale O'Reiley
❑ David Hart, Alternate, Area I
❑ Dennis Corrington, Alternate, Area II
❑ Tom Taylor, Alternate, Area III
❑ Adrian Williams, Alternate, Area IV
❑ Douglas Rape', ETJ Resident
❑ Mike Guido, Alternate,
Resident -At -Large
El Bill Davis, P&Z
❑ Kathleen Ireland, Parks & Rec
Alternate
❑ Bo Miles, Building & Land
Development
AWG
AMERICAN WIRE GROUP
A POWERFUL soy u r I C
1920 B. Hallandale Beach Blvd.
Suite PH8
Hallandale, Florida 33009
❑ Larry Marriott, Home Builders
Assoc.
❑ Tedi Ellison, Intergovernmental
Comm/Chamber of Commerce
❑ James Massey, Intergovernmental
Comm/TAMU Admin
El 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
Comm/TxDOT
❑ Michael Parks, Intergovernmental
Comm/BVCOG
❑ Gary Arnold, Intergovernmental
Comm/Brazos County Sheriff
❑ Gary Teston, Intergovernmental
Comm/ Easterwood Airport
NONE
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Suite PH8
Hallandale, Florida 33009
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
0 Lynn Mcllhaney ❑ Ben White NONE
Brazos Valley Council of
Governments
❑ Ron Silvia, Mayor X NONE
B/CS Metropolitan Planning
Organization
❑ Ron Silvia, Mayor NONE
BVCOG TMPA Regional Park
Project Advisory Board
0 Lynn Mcllhaney NONE
BVSWMA Policy Advisory
Board
❑ Ron Silvia, Mayor ❑ Chris Scotti NONE
City Center Committee
❑ Ron Silvia ❑ Ben White ❑ Dave Ruesink
NONE
Intergovernmental Committee
❑ Ron Gay ❑ Ben White ❑ John Happ
yNONE
AWG
AMERICAN WIRE GROUP
A POWERFUL SOLUTION
1920 E. Hallandale Beach Blvd.
Suite PH8
Hallandale, Florida 33009
❑ Dave Ruesink
NONE
❑ Dave Ruesink
Joint City/School
Intergovernmental Committee
❑ Ben White ❑ John Happ
Sister Cities Association
Ki NONE
Transportation Committee
❑ Ron Gay ❑ John Happ ❑ Lynn McIlhaney
❑ Ken Fogle 0 Linda LaSuit, MPO ❑ Dennis Christianson, TTI
❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT ` NONE
❑ Ron Gay
❑ John Nichols
❑ Joan Perry
Wolf Pen Creek Oversight
Committee
❑ Chris Scotti
❑ Marsha Sanford
❑ Sharon Colson
❑ Marc Chaloupka
❑ Jodi Warner
NONE
Describe each affiliation or business relationship with an employee checked in Question 4 above:
Adopted 01/13/06
AMERICAN u��--�.�__,.
A POWERFUL -IRE GROUP
SOL U 1 ) O N
1920 E Hallandale Beach Blvd,
Suite PHS
Hallandale, Florida 33009
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 of person doing bu j i ess with the governmental entity Date
AmalRIe* N WIRE G ERG
A POWERFUL 14244610.14u46
1920 E. Hallandale Beach Blvd.
Suite PH8
Hallandale, Florida 33009