Elliott ElectricCONFLICT OF INTEI
For vendor or other person
This questionnaire is being fi.
Government Code by a perso
By law this questionnaire mu
local government not later th
becomes aware of facts that r
176.006, Local Government
EST QUESTIONNAIRE
doing business with local governmental entity
ed in accordance with chapter 176 of the Local
i doing business with the governmental entity.
t be filed with the records administrator of the
n the 7th business day after the date the person
quire the statement to be filed. See Section
ode.
A person committs an offens if the person violates Section 176.006, Local
Government Code. An offens under this section is a Class C misdemeanor.
1. Name of person doing bt siness with local governmental entity.
:... :.>C.: v.v..............:.:.::..:.......
2.
FORM CIQ
OFFICE USE ONLY
Date Received
Check this bo if you are filing an update to a previously filed questionnaire.
(The law requires that you file
September 1 of the year for whi
not later than the 7th business
updated completed questionnaire with the appropriate filing authority not later than
h an activity described in Section 176.006(a), Local Government Code, is pending and
after the date the originally filed questionnaire becomes incomplete or inaccurate.)
3. Describe each affiliation r 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.
O Pete Caler, Landfill Mgr.
O Harvey Cargill, City Attorney
❑ John Woody, Utilities
❑ Michael Clancey, Police Chief
O Joey Dunn, Planning & Dev
O Don Fazzino, Legislative Liason
O Kim Foutz, Economic Dev
❑ Connie Hooks, City Secretary
❑ Jeff Kersten, Finance
NONE
❑ Charles McLemore, Public Works
O Becky Nugent, Public Relations
O Julie O'Connell, Human Resources
O 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 ocal government officer of the local government entity that is the subject of
this questionnaire.
❑ Ron Silvia, Mayor
❑ Ron Gay, Place 3
O Nancy Berry, Place 6
City of College Station Elected Officials
College Station City Council
❑ Ben White, Place 1
O Susan Lancaster, Place 4
41 NONE
❑ John Happ, Place 2
O Chris Scotti, Place 5
City o College Station Committees, Boards, and Commissions
❑ Larry Ringer, Chairman
❑ Eric Miller
O Lois Koontz
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
❑ Dan B. Sears, Chairman
❑ Mike Lane
O Steve Parker, alternate
❑ Karen Kasper, Merchant
❑ Joey Dunn, Dir. Planning &
iSi NONE
B/CS Library Committee
❑ Katherine Edwards
❑ Jeanne Mitchell
O James Bradford
Cemetery Committee
❑ Virginia Reese
O Mary Lind Biyan
,Hi 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
❑ Valerian Miranda, Architect
ev ❑ Robert Mosley, City Engineer
❑ Don Scherr
❑ Jo Berg
.12i NONE
❑ Kevin Myers
O Joe Wallace
O Frank Cox
❑ David Hart, alternate
A NONE
❑ Rick Lemmons, Business Owner
❑ Eric Barton, CD Coordinator
❑ Hillary Jessup, Chairman
❑ Marguerite Anthony
El Thomas Taylor
❑ Colleen Risinger
❑ Rebecca Eplen
❑ Rusleen Maurice
NONE
❑ Kathleen Ireland
O Carol Blaschke
❑ John Crompton
ra,. NONE
❑ Scott Shafer, Chairman
O Marsha Sanford
O Harold Strong
❑ Rick Heany
❑ Alan King
❑ Susie Cox, alternate
❑ Jay Goss, Chair
❑ Graham Sheffy
❑ Denise Whisenant
Historic Preservation Committee
❑ Bill Lancaster
❑ David Ruesink
❑ Ernie Wright
AlNONE
Joint Relief Funding Review
Committee
❑ J. Kevin Byrne
El Charlotte Mikulee
Parks and Recreation Board
❑ Glenn Schroeder
❑ Jeannie McCandless
❑ Harry Green
Planning and Zoning
Commission
❑ John Nichols
❑ Dennis Christiansen
NONE
Design Review Board
❑ Marsha Crenwelge
❑ Dipankar Sen
❑ Neal Nutall, Jr.
El Mary Sherwood
❑ Peggy Samson
El Jodi Warner
❑ Gary Thomas
❑ Gary Erwin
❑ Ken Reynolds
❑ Bill Davis
❑ Hunter Goodwin ❑ Nancy Sawtelle
❑ Ward Wells El Scott Shafer
❑ Robert Rayburn, alternate XNONE
Zoning Board of Adjustments
❑ Joshua Benn
❑ Donald Braune
❑ Derek Dictson
❑ John Richards
El Charles Taylor
34 NONE
Research Valley Partnership
Board of Directors
❑ David Hickson ❑ Larry Mariott
O Glenn Brown, City Mana : er iir NONE
❑ Sharon Colson, Chair
❑ Kenny Mallard
Wolf Pen Creek TIF Board
❑ Chris Scotti, Councilman
❑ Marsha Sanford, Vice Chair 0 Marc Chaloupka
O James Massey j* NONE
The following individuals a e appointed by the City Council to represent the City of College Station on
joint committees with other governmental agencies and community groups.
0 Susan Lancaster
❑ Ron Silvia, Mayor
❑ Ron Silvia, Mayor
❑ Susan Lancaster
❑ Ron Silvia, Mayor
Brazos County Health
Department
0 Nancy Berry 0 NONE
Brazos Valley Council of
Governments Board of Directors
Of NONE
B/CS Metropolitan Planning
Organization
91 NONE
BVCOG TMPA Regional Park
Project Advisory Board
NONE
BVSWMA Policy Advisory
Board
0 Susan Lancaster %NONE
❑ Ron Silvia
A NONE
❑ Nancy Berry
1 NONE
❑ Nancy Berry
[' NONE
❑ Ron Gay
❑ Ron Gay
❑ Linda LaSuit, MPO
❑ Bryan Woods, TxDOT
City Center Committee
❑ Ben White 0 Nancy Berry
Intergovernmental Committee
❑ Ben White 0 John Happ
Joint City/School
Intergovernmental Committee
0 Ben White 0 John Happ
Sister Cities Association
[NONE
Transportation Committee
❑ John Happ
0 Dennis Christianson, TTI
,Lii' NONE
❑ Ken Fogle
❑ Michael Parker, BVCOG
Wolf Pen Creek Oversight
Committee
❑ Ron Gay
❑ 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
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
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 • oing business with the governmental entity Date
Adopted 01/13/06