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C&D Property ServicesCONFLICT 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. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. ) /eVez-dire 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. ❑ 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 Dave Coleman, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. El Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Of icer ❑ Julie O'Connell, Human Resources ❑ Ed Spillane, Municipal Judge IC1 NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This section, item 5 including subparts A, W C & D, must be completed for each officer with whom the tiler 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, g, 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 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. 14IALA, Signature of person doing business with the vernmental entity y1J x/07 Date Adopted 01/13/06 ❑ Dave Ruesink irk NONE ❑ Dave Ruesink Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association NONE Transportation Committee ❑ Ron Gay ❑ John Happ 0 Lynn McIlhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT 7 NONE Wolf Pen Creek Oversight Committee ❑ Ron Gay ❑ Chris Scotti ❑ Marc Chaloupka ❑ John Nichols ❑ Marsha Sanford ❑ Jodi Warner El Joan Perry ❑ Sharon Colson NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01 /13/06 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 Mcllhaney ❑ Ben WhiteNONE Brazos Valley Council of Governments ❑ Mayor )i NONE B/CS Metropolitan Planning Organization O Mayor NONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcilhaney AI NONE BVSWMA Policy Advisory Board O Mayor 0 Chris Scotti 'A NONE City Center Committee ❑ Ron Silvia 0 Ben White 0 Dave Ruesink NONE Intergovernmental Committee ❑ Ron Gay 0 Ben White 0 John Happ J6 NONE ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ James Massey, Intergovernmental Comm/TAMU Admin ❑ Dr. Clark Ealy, Intergovernmental Comm/CSISD ❑ Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership ❑ Linda LaSut, Intergovernmental Comm/MPO ❑ Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce ❑ Rodney Weis, Intergovernmental Comm/TAMU Transit ❑ Dr. Colleen Netterville, Intergovernmental Comm/BISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/B VCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport N NONE ❑ Larry Hodges 0 Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis Cl Gregg Baird ❑ Chad Jones O Stephen Syptak, Chair ❑ Tom Kirkland NONE O Hugh Lindsay, Area 1 ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Marion I CNONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford k, Northgate Tax Increment Finance Board El David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I El Brian Bochner, Area II ❑ Laurie Corbelli, Area IlI ❑ Jerry Cooper, Area IV ❑ 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 .NONE O Roger Reese El Carolyn Berrow ❑ Anne Jackson El Dale O'Reiley El David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Area 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 ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright fl NONE ❑ Tedi Ellison ❑ Rusleen Maurice NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton 91 NONE ❑ John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong El Rick Heaney 0 Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Reba Ragdale Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford O Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen NONE Design Review Board El Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger Deborah Deitering ❑ El Joan Perry 0 Gary Thomas ❑ Gary Erwin El Derek Dictson ❑ Bill Davis O Hunter Goodwin ❑ Nancy Sawtelle El Ward Wells 0 John Nichols O Robert Rayburn, alternate ' NONE Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune O John Richards ❑ Thomas Mather 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 ❑ John Compton, Place 1 ❑ Lynn Mcllhaney, Place 4 El NONE ❑ James Massey, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ 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 11 NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum El(NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson F NONE CI Kevin Myers ❑ Joe Wallace n James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams 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. • ert,7_1(eS 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. O Robert Alley, Fire Chief 0 Michael Clancey, Police Chief 0 Charles McLemore, Public Works O Steve Beachy, Parks & Rec 0 Lance Simms, Planning & Dev 0 Becky Nugent, Public Relations O Glenn Brown, City Manager 0 John Woody, W/WW 0 Julie O'Connell, Human Resources O Olivia Burnside, Inf. Tech. 0 Terry Childers, Asst. City Mgr 0 Mark Smith, Asst. City Mgr O Pete Caler, Landfill Mgr. 0 Connie Hooks, City Secretary 0 Ed Spillane, Municipal Judge O Harvey Cargill, City Attorney 0 Jeff Kersten, Chief Fin.Officer 0 Cheryl Turney, Purchasing Mgr. O David Massey, Electric 0 Charles McLemore, Public Works ,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. City of College Station Elected Officials College Station City Council O Ron Silvia, Mayor 0 Ben White, Place 1 O Ron Gay, Place 3 0 Lynn Mcllhaney, Place 4 O David Ruesink, Place 6 ANONE O John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee O Larry Ringer, Chairman 0 Katherine Edwards 0 Don Scherr O Eric Miller 0 Jeanne Mitchell 0 Jo Berg O Lois Koontz 0 James Bradford X NONE Cemetery Committee O Sarah Adams, Chair 0 Virginia Reese O James Batenhorst 0 Mary Lind Bryan O David Chester 'Ft NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Kevin Myers O Joe Wallace O Dan B. Sears, Chairman 0 George McLean, Vice Chair 0 Frank Cox O Mike Lane 0 Larry D. Patton 0 David Hart, alternate O Steve Parker, alternate 0 David Ruesink, alternate A NONE Facade Improvement Program Advisory Committee O Karen Kasper, Merchant 0 Valerian Miranda, Architect 0 Rick Lemmons, Business Owner O Joey Dunn, Dir. Planning & Dev 0 Robert Mosley, City Engineer 0 Eric Barton, CD Coordinator NONE O Hillary Jessup, Chairman O Marguerite Anthony O Thomas Taylor O Colleen Risinger O Rebecca Eplen O Rusleen Maurice NONE O Kathleen Ireland O Carol Blaschke O John Crompton 3( 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 O 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 O Glenn Schroeder O Jeannie McCandless O Harry Green Planning and Zoning Commission O John Nichols O Dennis Christiansen y NONE Design Review Board O Marsha Crenwelge O Dipankar Sen O Neal Nutall, Jr. O Mary Sherwood O Peggy Samson O Jodi Warner O Gary Thomas O Gary Erwin O Ken Reynolds O Bill Davis O Hunter Goodwin 0 Nancy Sawtelle O Ward Wells 0 Scott Shafer O Robert Rayburn, alternate NONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O Derek Dictson O John Richards O Charles Taylor NONE O David Hickson O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Mariott ill NONE Wolf Pen Creek TIF Board 0 Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair 0 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. ❑ Susan Lancaster ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Susan Lancaster O Ron Silvia, Mayor Brazos County Health Department O Nancy Berry Brazos Valley Council of Governments Board of Directors NONE B/CS Metropolitan Planning Organization NONE BVCOG TMPA Regional Park Project Advisory Board 74- NONE BVSWMA Policy Advisory Board Susan Lancaster NONE NONE O Ron Silvia NONE O Nancy Berry NNONE O Nancy Berry 9i( 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 Sister Cities Association O Ron Gay ' NONE O Ron Gay O Linda LaSuit, MPO O Bryan Woods, TxDOT Transportation Committee O John Happ O Dennis Christianson, Ti'! NONE O John Happ O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay O Chris Scotti "1 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 FORM CIQ 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 od +usiness relationship. 6. 69,ZA Signature of person doing business with the gov mental entity Date Adopted 01/13/06