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B/CS ConstructionRandy Brumley - Form_CIQ_011306 w names.pdf Page 1 CONFLICT OF INTERS ST 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 mire the statement to be filed. See Section 176.006, Local Government C de. A person committs an offense if the person violates Section 176.006, Local Government Code. An offensender this section is a Class C misdemeanor. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing bus e ss with local governmental entity. 2. Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an upda ted completed questionnaire with the appropriate filing authority not later than September 1 of the year for which hn 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 relationshi p 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. ❑ Robert Alley, Fire Chief El Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief ❑ Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance P1QSN E ❑ Charles McLemore, Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources El Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. Describe each affiliation or business relationship with an employee checked in Question 3 above: Randy Brumley - Form_CIQ_011306 w nmes.pdf 4. Describe each affiliation urbusiness 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 O Ron Gay, Place 3 ❑ Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 ❑ John Happ, Place 2 O Susan Lancaster, Place 4 0 Chris Scotti, Place 5 (714rSNE City of oliege Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman O Eric Miller O Lois Koontz O Sarah Adams, Chair ❑ James Batenhorst O David Chester O Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate ❑ Karen Kasper, Merchant O Joey Dunn, Dir. Planning & De IKNONE B/CS Library Committee ❑ Katherine Edwards ❑ Don Scherr ❑ Jeanne Mitchell ❑ Jo Berg ❑ James Bradford - N E Cemetery Committee ❑ Virginia Reese ❑ Mary Lind Bryan 1:1•11*ON E Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair O Larry D. Patton ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee O Kevin Myers ❑ Joe Wallace ❑ Frank Cox ❑ David Hart, alternate gtd6N E ❑ Valerian Miranda, Architect ❑ Rick Lemmons, Business Owner O Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator Page 2 .Randy Brumley - Form CIQ 011306 w names.pdf Page 31 ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice I17NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton ®'NONE O Scott Shafer, Chairman O Marsha Sanford ❑ Harold Strong ❑ Rick Heany O Alan King O Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy O Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster ❑ David Ruesink O Ernie Wright Re ON E Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Glenn Schroeder ❑ Jeannie McCandless O Harry Green Planning and Zoning Commission ❑ John Nichols ❑ Dennis Christiansen ONE Design Review Board O Hunter Goodwin O Ward Wells O Robert Raybum, alternate Zoning Board of Adjustments O Joshua Benn ❑ Donald Braune O Derek Dictson ❑ Marsha Crenwelge ❑ Dipankar Sen O Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Nancy Sawtelle ❑ Scott Shafer ❑ NONE ❑ John Richards � O Charles Taylor , <N E Randy Brumley - Form_CIQ_011306 w names.pdf Page 4 I ❑ David Hickson O Glenn Brown, City Manag O Sharon Colson, Chair O Kenny Mallard Research Valley Partnership Board of Directors ❑ Marion IB'N ON E Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman O Marsha Sanford, Vice Chair 0 Marc Chaloupka O James Massey ONE 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. O Susan Lancaster ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Susan Lancaster O Ron Silvia, Mayor Brazos County Health Department 0 Nancy Berry I9'NONE Brazos Valley Council of Govern men is Board of Directors 2r N E B/CS Metropolitan Planning Organization IWNONE BVCOG TMPA Regional Park Project Advisory Board INE BVSWMA Policy Advisory Board O Susan Lancaster Eft<NE Randy Brumley - Form CIQ 011306 w names df Page 5 ❑ Ron Silvia ®'NOamNE ❑ Nancy Berry NONE ❑ NanyBerry [ANNE O Ron Gay ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT City Center Committee O Ben White 0 Nancy Berry In tergovern mental C ommittee O Ben White 0 John Happ Joint City/School In tergovern men to I Committee O Ben White 0 John Happ Sister Cities Association ®'NONE Transportation Committee O John Happ O Dennis Christianson, TTI Crl‘E O Ken Fogle O Michael Parker, BVCOG Wolf Pen C reek Oversigh t Committee O Ron Gay O Chris Scotti i�NE Describe each affiliation or busin ess relationship with an employee checked in Question 4 above: Adopted 01/13/06 Randy Brumley - Form_CIQ_011306 w n-mes.pdf CONFLICT OF INTE ST QUESTIONNAIRE For vendor or other person oing busin esswith local governmental entity FORM CIQ This section. item 5 including .ubparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or other relation hip. Attach additional pages to this Form CIQ as necessary. 5. Name of local government this section only if the answer officer with whom filer has affiliation or business relationship. (Complete to A, B,orC is YES. A. Is the local government offi 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 questionna e receiving or likely to receive taxable income from or at the direction of the local government officer namein this section AND the taxable income is not from the local governmental entity? Yes I1/I No C. Is the filer of this questionna• e affiliated with a corporation or other business entity that the local government officer serves as an officer or dir or, or holds an ownership of 10 percent or more? Yes D. Describe each affiliation or b No .isiness relationship. 6. Signature ofperson mental entity Date Adopted 01/13/06 Page 61