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Brown Reynolds Watford Architects, Inc.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 atter the date the person becomes aware of facts that require the statement to be filed. Sec 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. I. Name of person doing business with local governmental Inti 2. Brown Reynolds Watford Architects, Inc. FORM CIQ OFFICE USE ONLY Date Received Check this box if you are filing an update to a previously filed question sire. (The law requires that you file an updated completed questionnaire with the appropriate tiling authority not later than September I of the year for which an activity dccribed in Section 176,006{a), Local Government Code, is pending and not later than the 7th business day after the date the originally tiled 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. XXX Robert Ailey. Fire Chief ❑ Steve Reachy, Parks & Rec ❑ Glenn Brown, City Manager CI Olivia Burnside, Int'. Tech. • Pete Cater. Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ John Woody, Utilities XXX Michael Clancey, Police Chief • Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Charles McLemore. Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Charles Wood, Economic Icy XCIDQVIark Smith, Public Works ❑ Connie Ilooks, City Secretary ❑ Jeff Kersten, Finance El NONE ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. Describe each affiliation or business relationship with an employee checked in Question 3 above: Current projects with the City of College Station: Fire Station. No. 5 Fire Station No. 3 Police Station Renovation 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. El Ron Silvia, Mayor 0 Ron Gay, Place 3 CI Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council O Ben White, Place I 0 Susan Lancaster. Place 4 tc NONE O John Happ. Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Eric Miller 0 Lois Koontz B/CS Library Committee O Katherine Edwards O Jeanne Mitchell O James Bradford Cemetery Committee O Sarah Adams, Chair 0 Virginia Reese O James Batenhorst 0 Mary Lind Bryan O David Chester XR:14CNONE O Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate El Karen Kasper. Merchant O key Dunn, Dir. Planning & Dtw XiXJ NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O George McLean, Vice Chair O Larry D. Patton O David Ruesink, alternate Facade Improvement Program Advisory Committee O Valerian Miranda. Architect El Robert Mosley, City Engineer O Don Scherr ID Jo Berg XX IM NONE O Kevin Myers O Joe Wallace O Frank Cox O David Hart, alternate x311 NONE O Rick Lemmons, Business Owner [1 Erie Barton, Cl) Coordinator Research Valley Partnership Board or Directors LI David Hickson 0 Larry Marion Cilenn Brown, City Manager r21( NONE O Sharon Colson, Chair O Kenny Mallard Wolf Pen Creek TIF Board El Marsha Sanford. Vice Chair 0 James Massey 0 Chris Scotti. Councilman 0 Marc Chaloupka XXI 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 O Susan Lancaster 0 Nancy Berry X/ NONE Brazos Valley Council of Governments Board of Directors O Ron Silvia, Mayor a NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor X/Z NONE BVCOG TMPA Regional Park Project Advisory Board O Susan Lancaster '4)1 NONE BVSWMA Polley Advisory Board O Ron Silvia, Mayor 0 Susan Lancaster a NONE O Hillary Jessup, Chairman O Marguerite Anthony O Thomas Taylor CI Colleen Risinger 0 Rebecca Eplen O Rusleen Maurice n NONE CI Kathleen Ireland O Carol Blaschke O John Crompton NONE O Scott Shafer, Chairman O Marsha Sanford O Harold Strong O Rick Heany O Alan King O Susie Cox, alternate O Jay Goss, Chair O Graham Sheffy O Denise Whisenant Historic Preservation Committee El Bill Lancaster O David Ruesink El Ernie Wright n NONE Joint Relief Funding Review Committee El J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Glenn Schroeder O Jeannie McCandless O Harry Green . Planning and Zoning Corn m ission O John Nichols O Dennis Christiansen XJ NONE Design Review Board O Hunter Goodwin O Ward Wells O Robert Rayburn, alternate Zoning Board of Adjustments O Joshua Henn O Donald Braune Li Derek Dictsnn Li Marsha Crenwelge 0 Dipankar Sen El Neal Nutall, Jr. O Mary Sherwood O Peggy Samson O Jodi Warner O Gary Thomas O Gary Erwin O Ken Reynolds n Bill Davis O Nancy Sawielle O Scott Shafer )O NONE O John Richards O Charles Taylor la NONE O Ron Silvia X1 NONE O Nancy Berry a NONE El Nancy Berry NONE City Center Committee O Ben White 0 Nancy Berry Intergovernmental Committee O Ben White 0 John Happ Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association O Ron Gay NONE Transportation Committee O Ron Gay El John Happ O Linda LaSuit. MPO 0 Dennis Christianson, TTI O Bryan Woods, 1-x1XYT fa NONE O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay 0 Chris Scotti EkNONE 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, 11. C & D. must be completed for each officer with whom the filer has affiliation or other relationship. Attachadditional 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. 14/A 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 person doing business with the governmental entity Thomas W. Parker, AIA Director, Brown Reynolds Watford Architects, Inc. DMC Adopted 01/13/06