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Liteco Electric, Inc.Lemontree Park Field Lighting Bid #06-55 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. 2. Liteco Electric, Inc. 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. Name each employee or contractor of the local governmental entity who makes recommendations to a local government officer of the governmental entity with respect to expenditures of money AND describe the affiliation or business relationship. Robert Alley, Fire Chief Michael Clancey, Police Chief Charles McLemore, Public Works • ■ ■ Steve Beachy, Parks & Rec Joey Dunn, Planning & Dev Becky Nugent, Public Relations • ■ • Glenn Brown, City Manager Don Fazzino, Legislative Liason Julie O'Connell, Human Resources • ■ ■ Olivia Burnside, Inf. Tech. Kim Foutz, Economic Dev Mark Smith, Public Works • ■ IN Pete Caler, Landfill Mgr. Connie Hooks, City Secretary Ed Spillane, Municipal Judge ■ ■ • Harvey Cargill, City Attorney Jeff Kersten, Finance Cheryl Turney, Purchasing Mgr. ■ ■ ■ John Woody, Utilities NONE ■ F: Lemontree Park Field Lighting Bid #06-55 4. Name each local government officer who appoints or employs local government officers of the governmental entity for which this questionnaire is filed AND describe the affiliation or business relationship. City of College Station Elected Officials City of College Station Committees, Boards, and Commissions Construction Board of Adjustments and Appeals/Building & Standards Commission College Station City Council Sarah Adams, Chair Ron Silvia, Mayor Virginia Reese Ben White, Place 1 • John Happ, Place 2 • • ■ Mary Lind Bryan Ron Gay, Place 3 • Susan Lancaster, Place 4 ■ Joe Wallace Chris Scotti, Place 5 • ■ ■ Nancy Berry, Place 6 C NONE NONE • ■ City of College Station Committees, Boards, and Commissions Construction Board of Adjustments and Appeals/Building & Standards Commission B/CS Library Committee Sarah Adams, Chair Larry Ringer, Chairman Virginia Reese Katherine Edwards • Don Scherr • • ■ Mary Lind Bryan Eric Miller • Jeanne Mitchell ■ Joe Wallace Jo Berg • • ■ Lois Koontz K James Bradford NONE • ■ !J Construction Board of Adjustments and Appeals/Building & Standards Commission Cemetery Committee Sarah Adams, Chair ■ George McLean, Vice Chair Virginia Reese ❑ Kevin Myers • • • Mike Lane James Batenhorst ■ David Hart, alternate Mary Lind Bryan • ■ ■ Joe Wallace David Chester NONE • K Construction Board of Adjustments and Appeals/Building & Standards Commission ■ Dan B. Sears, Chairman ■ George McLean, Vice Chair ■ Frank Cox • Mike Lane ■ Larry D. Patton ■ David Hart, alternate C2( NONE El NONE • Steve Parker, alternate • David Ruesink, alternate Fagade Improvement Program Advisory Committee • Karen Kasper, Merchant ■ Valerian Miranda, Architect ■ Rick Lemmons, Business Owner • Joey Dunn, Dir. Planning & Dev ■ Robert Mosley, City Engineer • Eric Barton, CD Coordinator C2( NONE Lemontree Park Field Lighting Bid #06-55 Historic Preservation Committee Joint Relief Funding Review Committee Hillary Jessup, Chairman Rebecca Eplen Bill Lancaster J. Kevin Byrne Marsha Crenwelge ■ • • • Marguerite Anthony Rusleen Maurice David Ruesink Charlotte Mikulee Dipankar Sen • ■ ■ • Thomas Taylor NONE Ernie Wright Harry Green Neal Nutall, Jr. • • • ■ Colleen Risinger NONE • f;N Joint Relief Funding Review Committee Rebecca Eplen J. Kevin Byrne Mary Sherwood • • • Rusleen Maurice Charlotte Mikulee Peggy Samson • IN • NONE Harry Green 51 NONE Gary Erwin i Parks and Recreation Board Kathleen Ireland Glenn Schroeder Jodi Warner • ■ ■ Carol Blaschke Jeannie McCandless Gary Thomas IN ■ IN John Crompton Harry Green 51 NONE Gary Erwin • ■ ■ I:2 NONE Planning and Zoning Commission Scott Shafer, Chairman John Nichols Ken Reynolds ■ IN ■ Marsha Sanford Dennis Christiansen Bill Davis ■ ■ ■ Harold Strong NON 51 NONE NONE • R1 Design Review Board Rick Heany Hunter Goodwin Nancy Sawtelle ■ • • Alan King Ward Wells Scott Shafer ■ ■ ■ Susie Cox, alternate Robert Rayburn, alternate 51 NONE NONE ■ ■ 55 Zoning Board of Adjustments Jay Goss, Chair Joshua Benn John Richards • ■ ■ Graham Sheffy Donald Braune Charles Taylor • ■ ■ Denise Whisenant Derek Dictson 51 NONE ■ ■ Lemontree Park Field Lighting Bid #06-55 Research Valley Partnership Board of Directors Sharon Colson, Chair David Hickson Marsha Sanford, Vice Chair Larry Mariott • Chris Scotti, Councilman • ■ • Glenn Brown, City Manager ® NONE NONE • • I Wolf Pen Creek TIF Board Sharon Colson, Chair Marsha Sanford, Vice Chair • ■ • Marc Chaloupka Kenny Mallard James Massey ® NONE • • Lemontree Park Field Lighting Bid #06-55 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 x 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? IYes No x 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? —1 Yes x No D. Describe each affiliation or business relationship. 6. Signature of person doing business with the governmental entity Liteco Electric, Inc. P.O. Box 1265 Be1_lvi11e ,...'Tx 7.7.41.8_ . . 2/nq/nti Date Adopted 11/02/2005 Lemontree Park Field Lighting CERTIFICATION Bid #06-55