Power Reps, inc.CONFLICT OF INTEREST QUESTIONNAIRE
For vendor or other person doing business with local governmental entity
FORM CIQ
OFFICE USE ONLY
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.
Date Received
1. Name of person doing business with local governmental entity.
L..3 er `�c1 c_ , ?p�.r---.c- r J r
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
❑ John Woody, Utilities
❑ Michael Clancey, Police Chief
❑ Joey Dunn, Planning & Dev
El Don Fazzino, Legislative Liason
❑ Charles Wood, Economic Dev
❑ Connie Hooks, City Secretary
❑ Jeff Kersten, Finance
XNONE
❑ 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.
City of College Station Elected Officials
College Station City Council
❑ Ron Silvia, Mayor ❑ Ben White, Place 1
❑ Ron Gay, Place 3 ❑ Susan Lancaster, Place 4
❑ Nancy Berry, Place 6 )?:.NONE
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
City of College Station Committees, Boards, and Commissions
B/CS Library Committee
❑ Larry Ringer, Chairman ❑ Katherine Edwards ❑ Don Scherr
El Eric Miller ❑ Jeanne Mitchell ❑ Jo Berg
❑ Lois Koontz ❑ James Bradford NONE
Cemetery Committee
❑ Sarah Adams, Chair ❑ Virginia Reese
❑ James Batenhorst ❑ Mary Lind Bryan
❑ David Chester KNONE
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
❑ Kevin Myers
❑ Joe Wallace
❑ Dan B. Sears, Chairman ❑ George McLean, Vice Chair ❑ Frank Cox
❑ Mike Lane ❑ Larry D. Patton ❑ David Hart, alternate
❑ Steve Parker, alternate ❑ David Ruesink, alternate Y(NONE
Facade Improvement Program
Advisory Committee
❑ Karen Kasper, Merchant ❑ Valerian Miranda, Architect ❑ Rick Lemmons, Business Owner
❑ Joey Dunn, Dir. Planning & Dev ❑ Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator
*ONE
❑ Hillary Jessup, Chairman
❑ Marguerite Anthony
❑ Thomas Taylor
❑ Colleen Risinger
❑ Rebecca Eplen
❑ Rusleen Maurice
NONE
❑ Kathleen Ireland
❑ Carol Blaschke
❑ John Crompton
XNONE
❑ Scott Shafer, Chairman
❑ Marsha Sanford
❑ Harold Strong
❑ Rick Heany
❑ Alan King
El Susie Cox, alternate
❑ Jay Goss, Chair
❑ Graham Sheffy
0 Denise Whisenant
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
❑ Dennis Christiansen
NONE
Design Review Board
❑ Hunter Goodwin
❑ Ward Wells
El Robert Rayburn, alternate
Zoning Board of Adjustments
❑ Joshua Benn
❑ Donald Braune
❑ Derek Dictson
❑ Marsha Crenwelge
❑ Dipankar Sen
❑ Neal Nutall, Jr.
❑ Mary Sherwood
❑ Peggy Samson
❑ Jodi Warner
El Gary Thomas
❑ Gary Erwin
❑ Ken Reynolds
❑ Bill Davis
❑ Nancy Sawtelle
❑ Scott Shafer
NONE
❑ John Richards
❑ Charles Taylor
(NONE
❑ David Hickson
❑ Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
Research Valley Partnership
Board of Directors
❑ Larry Mariott
TNONE
Wolf Pen Creek TIF Board
❑ Chris Scotti, Councilman
❑ Marsha Sanford, Vice Chair ❑ 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
❑ Susan Lancaster ❑ Nancy Berry V -NONE
Brazos Valley Council of
Governments Board of Directors
❑ Ron Silvia, Mayor NONE
B/CS Metropolitan Planning
Organization
❑ Ron Silvia, Mayor 'NONE
BVCOG TMPA Regional Park
Project Advisory Board
❑ Susan Lancaster 1,LNONE
BVSWMA Policy Advisory
Board
❑ Ron Silvia, Mayor 0 Susan Lancaster NONE
❑ Ron Silvia
NONE
❑ Nancy Berry
NONE
❑ Nancy Berry
NONE
City Center Committee
❑ Ben White ❑ Nancy Berry
Intergovernmental Committee
❑ Ben White ❑ John Happ
Joint City/School
Intergovernmental Committee
❑ Ben White ❑ John Happ
Sister Cities Association
❑ Ron Gay yl,NONE
Transportation Committee
❑ Ron Gay ❑ John Happ
❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI
❑ Bryan Woods, TxDOT NONE
❑ Ken Fogle
❑ Michael Parker, BVCOG
Describe each affiliation or business relationship with an employee checked in Question 4 above:
Adopted 01/13/06
Wolf Pen Creek Oversight
Committee
Ron Gay
Chris Scotti
1 NONE
■
■
Describe each affiliation or business relationship with an employee checked in Question 4 above:
Adopted 01/13/06