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Bleyl & Associates07110/2006 15:29 979-268-1125 BLEYL AND ASSOCIATES CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity PAGE 02 FORM CIQ 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. BRETT McCULL'1 RE. OFFICE USE ONLY Date Received 2. _ Check this box if you arc 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. ❑ Robert Alley, Fire Chief ❑ Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager ❑ Olivia Burnside, Jnf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney Cl David Massey, Electric D Michael Ciancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW O Terry Childers, Asst. City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer ❑ Charles McLemore, Public Works ❑ Charles McLemore, Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Asst. City Mgr O Ed Spillane, Municipal Judge O Cheryl Turney, Purchasing Mgr. NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: 07/10/2006 15:29 979-268-1125 BLEYL AND ASSOCIATES PAGE 01 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 I. O Ron Gay, Place 3 0 Lynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 NONE City of College Station Committees, Boards, and Commissions D John Happ, Place 2 ❑ Chris Scotti, Place 5 B/CS Library Committee O Larry Ringer, Chairman ❑ Katherine Edwards ❑ Don Scherr D Eric Miller 0 Jeanne Mitchell ❑ Jo Berg ❑ Lois Koontz 0 James Bradford NONE Cemetery Committee o Sarah Adams, Chair O Virginia Reese ❑ James Batenhorst 0 Mary Lind Bryan O David Chester XNONE D Dan B. Sears, Chairman. ❑ Mike Lane ❑ Steve Parker, alternate Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair O Larry D. Patton ❑ David Ruesink. alternate Fagade Improvement Program Advisory Committee O Kevin Myers O Joe Wallace ❑ Frank Cox O David Hart, alternate NONE ❑ Karen Kasper, Merchant 0 Valerian. Miranda, Architect 0 Rick Lenvnons. Business Owner ❑ Joey Dunn, Dir. Planning & Dev ❑ Robert Mosley, City Engineer 0 Eric Barton, CD Coordinator NONE 07/10/2006 15:29 979-268-1125 © Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice NONE Q Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton )(NONE O Scott Shafer, Chairman ❑ Marsha Sanford ❑ Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox alternate O Jay Goss, Chair ❑ Graham Shetty O Denise Whisenant BLEYL AND ASSOCIATES PAGE 04 Historic Preservation Committee ❑ Bill Lancaster ❑ David Ruesink ❑ Ernie Wright NONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless ❑ Harry Green Planning and Zoning Commission ❑ John Nichols El Dennis Christiansen XNONE Design Review Board O Marsha Crenwelge El Dipankar Sen O Neal Nutall, Jr. ❑ Mary Sherwood O Peggy Samson ❑ Jodi Warner ❑ Gary Thomas O Gary Erwin ❑ Ken Reynolds O Bill Davis D Hunter Goodwin ❑ Nancy Sawtelle ❑ Ward Wells 0 Scott Shafer O Robert Rayburn, alternate XNONE Zoning Board of Adjustments ❑ Joshua Benn ❑ John Richards O Donald Braune 0 Charles Taylor D Derek Dictson NONE 07/10/2006 15:29 979-268-1125 BLEYL AND ASSOCIATES PAGE 05 Research Valley Partnership Board of Directors ❑ David Hickson ❑ Larry Mariott ❑ Glenn Brown, City Manager )<NONE Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Sharon Colson, Chair ❑ Marsha Sanford, Vice Chair ❑ Marc Chaloupka O Kenny Mallard ❑ James Massey XN 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 ❑ Susan Lancaster ❑ Nancy Berry NONE Brazos Valley Council of Governments Board of Directors O Ron Silvia, Mayor XNONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor )(NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Susan Lancaster NONE BVSWMA Policy Advisory Board El Ron Silvia, Mayor ❑ Susan Lancaster NONE 07/10/2006 15:29 979-268-1125 El Ron Silvia XNONE O Nancy Berry NONE El Nancy Berry XNONE BLEYL AND ASSOCIATES PAGE 06 City Center Committee ❑ Ben White 0 Nancy Berry Intergovernmental Committee ❑ Ben White 0 John Happ Joint City/School Intergovernmental Committee ❑ Ben White O John Happ Sister Cities Association ❑ Ron Gay XNONE Transportation Committee ❑ Ron Gay 0 John Happ ❑ Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Bryan Woods, TxDOT NONE O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee In Ron Gay In Chris Scotti )(NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 07/10/2006 15:29 979-268-1125 BLEYL AND ASSOCIATES PAGE Vii? 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 i No D. Describe each affiliation or business relationship. 6. Signature of per. • doing, /mess with the govemmental entity Date Adopted 01/13/06 07/10/2006 15:29 979-268-1125 1722 Broadmoor Suite 210 Bryan, Texas 77802 Tel. (979) 268-1125 Fax (979) 260-3849 Fax To: Cheryl K. Tumey, BLEYL AND ASSOCIATES PAGE 01 Bleyi & Associates From: Brett McCully, Sr. Engineer/Branch City of College Station Manager Fox: (979) 764-3899 Pages: (6) Pages Including Cover Sheet Phone: (979) 764-3899 Date: July 13, 2006