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Doughtie Construction CompanyCONFLICT 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. Ton Dou•htie - Dou•htie Construction Co. Inc FORM CIQ OFFICE USE ONLY Date Received x 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. 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. ❑ Glenn Brown, City Manager ❑ Robert Alley, Fire Chief ❑ Pete Caler, Landfill Mgr. ❑ David Gwin, Economic Dev. ❑ David Massey, Electric ❑ Bob Cowell, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary ❑ Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ JuUHO'&RnnH3l)Human Resources ❑ Ed Spillane, Municipal Judge Lia NONE Describe each affiliation or business relationship with an employee checked in n uestion 3 above: 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. ❑ Ben White, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ OPEN, Place I ❑ Lynn Mcllhaney, Place 4 11 NONE ❑ James Massey, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Katherine Edwards ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate ❑ NONE ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum CR NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson ❑ NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas. alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright • NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering El Rusleen Maurice ❑ Reba Ragdale ❑ ® NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton ® NONE ❑ John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong ❑ Rick Heaney ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant C NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen • NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn. alternate Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Nancy Sawtelle ❑ John Nichols 1 NONE ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland at NI NE ❑ e ugh i indsay, Area I ❑ John Crompton, Area Il ❑ Steve Arden, Area III ❑ e ugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember ❑ e illary Jessup, e istoric Preservation ❑ i loyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Mariott ❑ NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford • NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ i aurie Corbelli, Area III ❑ Jerry Cooper, Area IV ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig e all. ResidentiAtJi arge ❑ i ynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin. Parks & Rec ❑ i arry e askins, Northgate District Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka 1] NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ DDe O'Reiley ❑ David e art, Alternate, Area I ❑ Dennis Corrington, Alternate. Area II ❑ Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate. Area IV ❑ DRuJ lIWIFe', ETJ ReVCenW ❑ Mike Guido, Alternate, ResidentJAtJi arge ❑ Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate ❑ Bo Miles, Building & i and Development i arry Marriott, e ome Builders ‘ir Assoc. 0 Tedi Ellison, Intergovernmental Comm/Chamber of Commerce O James Massey, Intergovernmental Comm/TAMU Admin O Dr. Clark Ealy, Intergovernmental Comm/CS1SD O Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership El i inda i aSut, Intergovernmental Comm/MPI Li i indsey Guindi, Intergovernmental Comm/Chamber of Commerce O Rodney Weis, Intergovernmental Comm/TAMU Transit O Dr. Colleen Netterville, Intergovernmental Comm/BISD O Margie i ucas, Intergovernmental Comm/ Brazos Transit District O Chad Bohne. Intergovernmental Comm/TxD1 T O Michael Parks, Intergovernmental Comm/BVCI G O Gary Arnold. Intergovernmental Comm/Brazos County Sheriff 0 Gary Teston, Intergovernmental Comm/ Easterwood Airport a NI NE 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. ❑ Lynn Mcllhaney ❑ Mayor E Mayor ❑ Lynn Mcllhaney E Mayor ❑ Ron Silvia 11 NONE ❑ Ron Gay ® NONE Brazos County Health Department ❑ Ben White [l NONE Brazos Valley Council of Governments la NONE B/CS Metropolitan Planning Organization EJc NONE BVCOG TMPA Regional Park Project Advisory Board E NONE BVSWMA Policy Advisory Board ❑ Chris Scotti City Center Committee ❑ Ben White Intergovernmental Committee ❑ Ben White a NONE ❑ Dave Ruesink ❑ John Happ ❑ Dave Ruesink ❑ NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink EJ NONE ❑ Ron Gay ❑ Ken Fogle ❑ Michael Parker, BVCOG ❑ Ron Gay rlow ❑ John Nichols ❑ Joan Perry Transportation Committee ❑ John Happ ❑ Linda LaSuit. MPO ❑ Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford ❑ Sharon Colson El Lynn Mcllhaney ❑ Dennis Christianson, TTI NONE El Marc Chaloupka ❑ Jodi Warner ® NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 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 iatiw 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. Signature o person doibusiness with the governmental entity 7/25/07 Date Adopted 01/13/06 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. Dtxxttie CtrStrtx;ticn (b, 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. 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, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ David Massey, Electric ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ 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 ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. CE NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: 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. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 O Lynn Mcllhaney, Place 4 .,NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Eric Miller ❑ Lois Koontz B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Sarah Adams, Chair . ❑ Virginia Reese O James Batenhorst ❑ Mary Lind Bryan O David Chester NONE ❑ Dan B. Sears, Chairman ❑ Mike Lane O Steve Parker, alternate ❑ Karen Kasper, Merchant O Joey Dunn, Dir. Planning & Dev ,NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair ❑ Larry D. Patton O David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Valerian Miranda, Architect O Robert Mosley, City Engineer ❑ Don Scherr ❑ Jo Berg NONE ❑ Kevin Myers ❑ Joe Wallace ❑ Frank Cox ❑ David Hart, alternate J NONE ❑ Rick Lemmons, Business Owner ❑ Eric Barton, CD Coordinator Historic Preservation Committee ❑ Hillary Jessup, Chairman 0 Bill Lancaster ❑ Marguerite Anthony ❑ David Ruesink Cl Thomas Taylor ❑ Ernie Wright O Colleen Risinger ,NONE O Rebecca Eplen O Rusleen Maurice NONE ❑ Kathleen Ireland O Carol Blaschke O John Crompton ANONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless ❑ Harry Green Planning and Zoning Commission ❑ Scott Shafer, Chairman ❑ John Nichols ❑ Marsha Sanford ❑ Dennis Christiansen ❑ Harold Strong J:KNONE Design Review Board ❑ Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Rick Heany 0 Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King 0 Ward Wells ❑ Scott Shafer ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate IQIONE Zoning Board of Adjustments ❑ Jay Goss, Chair ❑ Joshua Benn ❑ John Richards ❑ Graham Sheffy ❑ Donald Braune ❑ Charles Taylor 0 Denise Whisenant 0 Derek Dictson cNONE ❑ David Hickson ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Mariott NONE Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair Cl Marc Chaloupka ❑ James Massey !NONE 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 Cl Susan Lancaster 0 Nancy Berry iKNONE Brazos Valley Council of Governments Board of Directors ❑ Ron Silvia, Mayor (;NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor JR. NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Susan Lancaster 'NONE BVSWMA Policy Advisory Board El Ron Silvia, Mayor 0 Susan Lancaster NONE ❑ Ron Silvia NONE ❑ Nancy Berry ji(NONE ❑ Nancy Berry %NONE City Center Committee ❑ Ben White 0 Nancy Berry Intergovernmental Committee ❑ Ben White Cl John Happ Joint City/School Intergovernmental Committee 0 Ben White ❑ John Happ Sister Cities Association Cl Ron Gay ,NONE ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI .ONE O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee 0 Ron Gay ❑ Chris Scotti _PONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE 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. FORM CIQ 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 X 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. 1ibtu 8- 11- v to Signature d person doing business with the governmental entity Date Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Tony Doughtie - Doughtie Construction Co., Inc. 2. 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. 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, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney 29 NONE ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ Terry Childers, Deputy City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer 0 ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. ❑ David Massey, Electric Describe each affiliation or business relationship with an employee checked in Question 3 above: 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. ❑ Ron Silvia, Mayor O Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place I ❑ Lynn Mcllhaney, Place 4 ki NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Jennifer Bohac ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate 11 NONE Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum $1 NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson 111;1 NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright N NONE ❑ Rebecca Eplen ❑ Rusleen Maurice IliI NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton ® NONE O John Nichols, Chair ❑ Marsha Sanford Cl Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant KI NONE Historic Preservation Committee O Bill Lancaster ❑ Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen 2 NONE Design Review Board O Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments O Joshua Benn ❑ Donald Braune ❑ Marguerite Anthony O Meredith Waller O Colleen Risinger ❑ Deborah Deitering Cl Peggy Samson ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson O Bill Davis ❑ Nancy Sawtelle ❑ John Nichols 4 NONE ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird O Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland A NONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Mariott N NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford 1%1 NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I O Brian Bochner, Area II ❑ Laurie Corbelli, Area III O Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka 14 NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Riley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate. Arca II ❑ Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate. Area IV ❑ Douglas Rape', ETJ Resident ❑ Mike Guido, Alternate, Resident -At -Large ❑ Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate ❑ Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. O Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ James Massey, Intergovernmental Comm/TAMU Admin O Dr. Clark Ealy, Intergovernmental Comm/CSISD ❑ Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership O Linda LaSut, Intergovernmental Comm/MPO O Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce O Rodney Weis, Intergovernmental Comm/TAMU Transit O Dr. Colleen Netterville, Intergovernmental Comm/BISD O Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG Gary Arnold, Intergovernmental Comm/Brazos County Sheriff Gary Teston, Intergovernmental Comm/ Easterwood Airport NONE 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 ❑ Lynn McIlhaney ❑ Ben White EYLNONE Brazos Valley Council of Governments ❑ Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor El NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Lynn Mcllhaney I] NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor 0 Chris Scotti J NONE City Center Committee ❑ Ron Silvia 0 Ben White ❑ Dave Ruesink NONE Intergovernmental Committee ❑ Ron Gay ❑ Ben White ❑ John Happ gI NONE El Dave Ruesink NONE Joint City/School Intergovernmental Committee 0 Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink fZ NONE Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle ❑ Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT g NONE El Ron Gay Wolf Pen Creek Oversight Committee 0 Chris Scotti !$I NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 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. Signature of p(3. en doing business with the governmental entity Date Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Tony Doughtie - Doughtie Construction Co, Inc. 2. 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. 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 El 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 ❑ Charles Wood, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance ® NONE ❑ Charles McLemore, Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ 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: 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. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 O Susan Lancaster, Place 4 NONE ❑ John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Larry Ringer, Chairman ❑ Katherine Edwards ❑ Don Scherr ❑ Eric Miller 0 Jeanne Mitchell ❑ Jo Berg ❑ Lois Koontz 0 James Bradford I NONE ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate Cemetery Committee ❑ Virginia Reese ❑ Mary Lind Bryan ER NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair ❑ Larry D. Patton ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Kevin Myers O Joe Wallace ❑ Frank Cox ❑ David Hart, alternate ® NONE O Karen Kasper, Merchant 0 Valerian Miranda, Architect 0 Rick Lemmons, Business Owner ❑ Joey Dunn, Dir. Planning & Dev ❑ Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator ER NONE ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony O Thomas Taylor ❑ Colleen Risinger O Rebecca Eplen O Rusleen Maurice ® NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton (� NONE ❑ Scott Shafer, Chairman ❑ Marsha Sanford ❑ Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy ❑ Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster O David Ruesink O Ernie Wright ® NONE Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless ❑ Harry Green Planning and Zoning Commission ❑ John Nichols ❑ Dennis Christiansen ® NONE Design Review Board ❑ Hunter Goodwin O Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune O Derek Dictson ❑ Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. O Mary Sherwood O Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds O Bill Davis O Nancy Sawtelle ❑ Scott Shafer l NONE O John Richards ❑ Charles Taylor J NONE ❑ David Hickson O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Mariott ® NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey ❑ Chris Scotti, Councilman El Marc Chaloupka ll NONE 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 ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Susan Lancaster ❑ Ron Silvia, Mayor ❑ Nancy Berry El NONE Brazos Valley Council of Governments Board of Directors ll NONE B/CS Metropolitan Planning Organization El NONE BVCOG TMPA Regional Park Project Advisory Board ® NONE BVSWMA Policy Advisory Board 0 Susan Lancaster ® NONE ❑ Ron Silvia Et NONE ❑ Nancy Berry M NONE ❑ Nancy Berry ® NONE City Center Committee 0 Ben White 0 Nancy Berry Intergovernmental Committee 0 Ben White 0 John Happ Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association O Ron Gay ® NONE ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT Transportation Committee ❑ John Happ O Dennis Christianson, TTI ® NONE ❑ Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee 0 Ron Gay 0 Chris Scotti ® NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 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, Signature of pen doing business with the governmental entity Tony Doughtie 5/26/06 Date Adopted 01/13/06