Sierra Mfg. Inc.
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CONFLICT OF INTEREST QUESTIONNAIRE
For vendor or other pers6n doing business with local governmental entity
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FORM CIQ
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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 just 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 thai require the statement to be filed. See Section
176.006, Local Government Code.
A person committs an offJse if the person violates Section 176.006, Local
Government Code. An offense under this section is a Class C misdemeanor.
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l. Name of person doing business with local governmental entity.
~~\. ~ 00 ~~.~ t'vLC-~,A.:R~~JJ'9q? ,s.g",
2. I
D Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you filJ an updated completed questionnaire with the appropriate filing authority not later than
September I of the year for which an activity described in Section I 76.006(a). Local Government Code. is pending and
not later than the 7th business 'day after the date the originally tiled questionnaire becomes incomplete or inaccurate.)
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3. Describe each affiliation or business relationship \lith an employee or contractor of the local
governmental entiiy ,vho hwkes recommendations to a local government officer of the local governmental
entity with respect to expenditure of money.
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o Robert Alley, Fire Chief
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o Steve Beachy, Parks & Rec
o Glenn Brown, City Man~ger
o Olivia Burnside, Inf. Te~h.
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o Pete Caler, Landfill Mgr.
o Harvey Cargill, City Att~rney
o John Woody, Utilities
OFFICE USE ONLY
Date Received
01-24-06P02:31 RCVD
o Michael Clancey, Police Chief
o Charles McLemore, Public Works
o Joey Dunn, Planning & Dev
o Don Fazzino, Legislative Liason
o Kim Foutz, Economic Dev
o Becky Nugent, Public Relations
o Julie O'Connell, Human Resources
o Mark Smith, Public Works
o Connie Hooks, City Secretary
o Ed Spillane, Municipal Judge
o Cheryl Turney, Purchasing Mgr.
o Jeff Kersten, Finance
I\1'NONE
Describe each affiliation or business relationship with an employee checked in Question 3 above;
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4. Deserihe eaeh affiliatio1n or business relationship with a person who is a local government officer and
who appoints or employs ~ local government officer of the local government entity that is the subject of
this questionnaire.
City of College Station Elected Offieials
College Station City Council
o Ron Silvia, Mayor
o Ron Gay, Place 3
o Nancy Berry, Place 6
o Ben White, Place I
o Susan Lancaster, Place 4
o John Happ, Place 2
o Chris Scotti, Place 5
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Citi of College Station Committees, Boards, and Commissions
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o Larry Ringer, Chairman!
o Eric Miller I
~NONE
B/CS Library Committee
o Katherine Edwards
o Don Scherr
o Jeanne Mitchell
o Jo Berg
o Lois Koontz
o James Bradford
p-'NONE
Cemetery Committee
o Sarah Adams, Chair
o James Batenhorst
o David Chester
o Virginia Reese 0 Kevin Myers
o Mary Lind Bryan 0 Joe Wallace
~NONE
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o Dan B. Sears, Chairman:
o Mike Lane I
o Steve Parker, altemate I
Construction Board of
Adjustments and
AppealslBuilding & Standards
Commission
o George McLean, Vice Chair 0 Frank Cox
o Larry D. Patton 0 David Hart, altemate
o David Ruesink, alternate p--NONE
F:u;ade I mprovemcnt Program
Adyiso/'y Committee
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o Karen Kasper, Merchant
o Joey Dunn, Oir. Planningl& Oev
r/ NONE
o Valerian Miranda, Architect
o Robert Mosley, City Engineer
o Rick Lemmons, Business Owner
o Eric Barton, CD Coordinator
Historic Preservation Committee
o Hillary Jessup, Chairmln
o Marguerite Anthony
o Thomas Taylor
o Colleen Risinger
o Bill Lancaster
o David Ruesink
o Ernie Wright
IV!"NONE
Joint Relief Funding Review
Committee
o Rebecca Eplen
o Rusleen Maurice
o J. Kevin Byrne
o Charlotte Mikulee
D"NONE
Parks and Recreation Board
o Kathleen Ireland
o Carol Blaschke
o Glenn Schroeder
o Jeannie McCandless
o John Crompton
o Harry Green
V3'NONE
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o Scott Shafer, Chairman \
o Marsha Sanford
o Harold Strong
Planning and Zoning
Commission
o John Nichols
o Dennis Christiansen
~NONE
Design Review Board
ORick Heany
o Alan King
o Susie Cox, alternate
o Hunter Goodwin
o Ward Wells
o Robert Rayburn, alternate
Zoning Board of Adjustments
o Jay Goss, Chair
o Graham Sheffy
o Denise Whisenant
o Joshua Benn
o Donald Braune
o Derek Dictson
o Marsha Crenwelge
o Dipankar Sen
ONeal Nutall, Jr.
o Mary Sherwood
o Peggy Samson
o Jodi Warner
o Gary Thomas
o Gary Erwin
o Ken Reynolds
o Bill Davis
o Nancy Sawtelle
o Scott Shafer
pt1 NONE
o John Richards
o Charles Taylor
i;iNONE
o David Hickson
o Glenn Brown, City Ma~ager
o Sharon Colson, Chair
o Kenny MaIlard
Research Valley Partnership
Board of Directors
o Larry Mariott
v< NONE
Wolf Pen Creek TIF Board
o Marsha Sanford, Vice Chair
o James Massey
o Chris Scotti, Councilman
o Marc Chaloupka
P(NONE
The following individuals are appointed by the City Council to represent the City of College Station on
joint committees with oth'er governmental agencies and community groups.
o Susan Lancaster
o Ron Silvia, Mayor
o Ron Silvia, Mayor
o Susan Lancaster
o Ron Silvia, Mayor
Brazos County Health
Depllrtment
o Nancy Berry
Brazos Valley Council of
Governments Board of Din'ctors
Ii NONE
B/CS Metropolitan Planning
Organization
v1' NONE
BVCOG TMPA Regional Park
Project Advisory Board
rJ NONE
BVSWMA Policy Ad\'isory
Boanl
o Susan Lancaster
~NONE
~ONE
City Center Committee
o Ron Silvia
o Ben White
o Nancy Berry
~NONE
Intcrgovernmental Committee
o Nancy Berry
V"NONE
o Ben White
o John Happ
Joint City/School
Intergovernmental Committee
o Nancy Berry
~NONE
o Ben White
o John Happ
Sistcr Cities Association
o Ron Gay
plNONE
Transportation Committec
o Ron Gay
Olinda LaSuit, MPO
o Bryan Woods, TxDOT
o John Ilapp
o Dennis Christianson, TTI
o Ken Fogle
o Michael Parker, BVCOG
It!'NONE
Wolf Pen Creek Oversight
Committee
o Ron Gay o Chris Scotti ~ONE
Describe each affiliation or business relationship with an employee checked in Question 4 above:
Adopted 01113/06
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor or other person doing business with local governmental entity
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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 C1Q as necessary.
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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?
D Yes I
D
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 n~med in this section AND the taxable income is not from the local govemmental
entity?
D
,
Yes
D
No
C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local
government officer serves ds an officcr or director, or holds an ownership of 10 perccnt or more?
DYes'
D
No
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D. Describe each affiliation or business relationship.
6.
L~
I Jz L/ /DIo
Signature of person doing business with the governmental entity
Date
Adopted 01/13/06