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C.F. McDonald ElectricI,emontree Park Field Ligh'ing Bid #O6 -S5 CONFLICT 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. 1. Name of person doing business with local governmental entity. C. F. McDonald Electric, Inc. 2. FORM CIQ 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 Charles McLemore, Public Works • ■ Michael Clancey, Police Chief ■ Steve Beachy, Parks & Rec Becky Nugent, Public Relations • • Joey Dunn, Planning & Dev ■ Glenn Brown, City Manager Julie O'Connell, Human Resources • ■ Don Fazzino, Legislative Liason ■ Olivia Burnside. Inf. Tech. Mark Smith, Public Works • • Kim Foutz, Economic Dev ■ Pete Caler, Landfill Mgr. El Connie Hooks, City Secretary Ed Spillane, Municipal Judge • ■ Harvey Cargill, City Attorney Cheryl Turney, Purchasing Mgr. • IN Jeff Kersten, Finance ■ John Wcndy, Utilities MNONE ■ 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 B/CS Library Committee Ron Silvia, Mayor Larry Ringer, Chairman Valerian Miranda, Architect John Happ, Place 2 • ■ Ben White, Place 1 ■ ■ • • Ron Gay, Place 3 Joey Dunn, Dir. Planning & Dev Eric Miller Chris Scotti, Place 5 ■ Susan Lancaster, Place 4 ■ Jo Berg ■ ■ Nancy Berry, Place 6 )12g NONE a NONE • • • James Bradford NONE City of College Station Committees, Boards, and Commissions Construction Board of Adjustments and Appeals/Building & Standards Commission Cemetery Committee B/CS Library Committee Sarah Adams, Chair Larry Ringer, Chairman Valerian Miranda, Architect Katherine Edwards • Don Scherr • ■ • • James Batenhorst Joey Dunn, Dir. Planning & Dev Eric Miller • Steve Parker, alternate Jeanne Mitchell Joe Wallace Jo Berg ■ ■ • David Chester a NONE • Lois Koontz • James Bradford NONE ■ Construction Board of Adjustments and Appeals/Building & Standards Commission Cemetery Committee • Dan B. Sears, Chairman Sarah Adams, Chair Valerian Miranda, Architect Kevin Myers • • Virginia Reese • IN • James Batenhorst Joey Dunn, Dir. Planning & Dev • David Hart, alternate • Steve Parker, alternate • Mary Lind Bryan Joe Wallace ■ David Ruesink, • ■ David Chester a NONE NONE • Construction Board of Adjustments and Appeals/Building & Standards Commission Facade Improvement Program Advisory Committee • Dan B. Sears, Chairman • George McLean, Valerian Miranda, Architect Vice Chair ■ Frank Cox • • • Mike Lane ■ Larry D. Patton Joey Dunn, Dir. Planning & Dev • David Hart, alternate • Steve Parker, alternate Ngl NONE ■ David Ruesink, • alternate Facade 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 • • ■ NONE Lemontree Park Field Lighting Bid #06-55 Historic Preservation Committee Parks and Recreation Board Joint Relief Funding Review Committee Hillary Jessup, Chairman Kathleen Ireland Bill Lancaster J. Kevin Byrne Marsha Crenwelge • • • • • ■ Marguerite Anthony Marsha Sanford David Ruesink Donald Braune Dipankar Sen • • ■ • Thomas Taylor John Crompton Ernie Wright Harry Green Neal Nutall, Jr. • • • • Colleen Risinger Xl NONE Parks and Recreation Board Joint Relief Funding Review Committee Design Review Board Kathleen Ireland • J. Kevin Byrne Mary Sherwood • Rebecca Eplen • • • Carol Blaschke Marsha Sanford Charlotte Mikulee Donald Braune Peggy Samson • Rusleen Maurice ■ ■ • XNONE John Crompton MX NONE Harry Green Robert Rayburn, alternate Gary Erwin • • Parks and Recreation Board Planning and Zoning Commission Design Review Board Kathleen Ireland • Glenn Schroeder Jodi Warner • • ■ • Carol Blaschke Marsha Sanford Jeannie McCandless Donald Braune Gary Thomas • • ■ ■ • John Crompton MX NONE Harry Green Robert Rayburn, alternate Gary Erwin • • ■ V] NONE Zoning Board of Adjustments Planning and Zoning Commission Design Review Board Jay Goss, Chair • Scott Shafer, Chairman Hunter Goodwin Ken Reynolds ■ John Nichols ■ ■ • Marsha Sanford Alan King Donald Braune Ward Wells • Dennis Christiansen Bill Davis ■ ■ • Harold Strong MX NONE IN Robert Rayburn, alternate NKNONE ■ • Zoning Board of Adjustments Design Review Board Jay Goss, Chair Rick Heany Hunter Goodwin ■ • ■ ■ • Nancy Sawtelle Grahan1 Sheffy Alan King Donald Braune Ward Wells Charles Taylor ■ ■ ■ Scott Shafer IN Susie Cox, alternate IN Robert Rayburn, alternate NKNONE ■ • Zoning Board of Adjustments Jay Goss, Chair Joshua Benn John Richards ■ IN ■ Grahan1 Sheffy Donald Braune Charles Taylor • ■ • IN Denise Whisenant IN Derek Dictson MCNONE Lemontree Park Field Lighting Bid #06-55 Wolf Pen Creek TIF Board ❑ Sharon Colson, Chair ❑ Marsha Sanford, Vice Chair 0 Kenny Mallard ❑ James Massey ❑ Marc Chaloupka r$ NONE Research Valley Partnership Board of Directors David Hickson Chris Scotti, Councilman ■ • Larry Mariott • • Glenn Brown, City Manager Er NONE Wolf Pen Creek TIF Board ❑ Sharon Colson, Chair ❑ Marsha Sanford, Vice Chair 0 Kenny Mallard ❑ James Massey ❑ Marc Chaloupka r$ 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 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. Harry Keller, Vice President Signature of person doing business with the governmental entity Date 2/09/06 Adopted 11/02/2005