Ashlock's NurseryCONFLICT 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.
2.
A\ock 'S
Ivvrsef-.
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
El Pete Caler, Landfill Mgr.
❑ David Gwin, Economic Dev.
El David Massey, Electric
❑ Lance Simms, 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.
El Olivia Burnside, Inf. Tech.
E l Michael Clancey, Police Chief
❑ Jeff Kersten, Chief Fin.Officer
❑ Julie O'Com}ell, Human Resources
❑ Fd Spillane, Municipal Judge
NONE
Describe each affiliation or business relationship with an employee checked in Question 3 above:
No"
4. Describe each affiliation or business relationship with a person who is a local gov+rnment 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 0 Ben White, Place 1
O Ron Gay, Place 3 0 Lyrin Mcllhaney, Place 4
❑ David Ruesink, Place 6 ��''NONE
❑ John Ham, 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
O Dan B. Sears, Chairman
❑ Mike Lane
uI❑ eve Parker, alternate
Ed' NONE
B/CS Library Committee
❑ Katherine Edwards 0 Don Scherr
❑ Jeanne Mitchell ❑ B.9rroll Johnson
O James Bradford ONE
Cemetery Committee
❑ Virginia Reese
❑ Weldon Kruger
❑ RC'locum
ONE
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
O Frank Cox
❑ Larry D. Patton
❑ Glenn Thomas, alternate
❑ Kevin Myers
❑ Joe Wallace
❑ James Matson
O David Hart
O Charles Thornas, alternate
❑ Quinn Williams
❑ Hillary Jessup, Chairman
❑ Haskell Monroe
CIie Wright
1412z
ONE
Historic Preservation Committee
❑ Bill Lancaster
❑ Jane Hughey
❑ Neal Nutall, Jr.
Joint Relief Funding Review
Committee
❑ Margueritje Anthony
❑ Meredith ' Valler
❑ Colleen Risinger
❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering
O Rusleen Maurice 0 Reba Ragdale ❑
GVINONE
❑ Jodi Warner, Chair
❑ Shawn Rhodes
❑ hn Crompton
NONE
Parks and Recreation Board
❑ Kathleen Ireland
❑ Jody Ford
❑ Harry Green
Planning and Zoning
Commission
❑ John Nichols, Chair ❑ Glenn Schroeder
❑ Marsha Sanford ❑ D is Christiansen
❑ Harold Strong D/NONE
❑ Rick Heaney
❑ Alan King
O Susie Cox, alternate
❑ Jay Goss, Chair
❑ enise Whisenant
NONE
Design Review Board
❑ Joan Perry
❑ Gary Thomas
❑ Gary Erwin
❑ Derek DictsOn
❑ Bill Davis
❑ Hunter Goodwin ❑ Nancy SawteIlle
❑ Ward Wells ❑ Joh icholsli
❑ Robert Rayburn, alternate ai<ONE
Zoning Board of Adjustments
❑ Joshua Benn
❑ Donald Braune
❑ John Richards
❑ Thomas Mather
❑ Larry Hodges
❑ Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
❑ Don Lewis
O Gregg Baird
❑ Chad Jones
❑ Stephen Syptak, Chair
O To i Kirkland
ONE
❑ Hugh Lindsay, Area I
❑ John Crompton, Area II
O 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
D Lloyd Wasserman, County
Commission
Research Valley Partnership
Board of Directors
❑ llLarry Mariott
ONE
Wolf Pen Creek TIF Board
❑ Marsha Sanford, Vice Chair
❑ James Massey
Outside Agency Funding Review
❑ Charles Taylor
❑ S ryl Welford
NONE
Northgate Tax Increment
Finance Board
❑ David Scarmardo
❑ Glenn Thomas
Comprehensive Plan Committee
❑ John Richards, Area I
❑ Brian Bochner, Area II
Cl Laurie Corbelli, Area III
❑ 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
0w2arc Chalbupka
ONE II
❑ Roger Ree4e
❑ Carolyn Belrrow
❑ Anne Jackson
❑ Dale O'Reiley
❑ David Hart, Alternate, Area I
O Dennis Corrington, Alternate, Area 11
❑ Tom Taylor,IAlternate, Area III
CIAdrian Williams, Alternate, Area IV
❑ Douglas Rape', ETJ Resident
❑ Mike Guido, (Alternate,
Resident -At -Large
O Bill Davis, P&Z
❑ Kathleen Ireland, Parks & Rec
Alternate
❑ Bo Miles, Building & Land
Development)
❑ 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
CommTINDOT
❑ Michael Parks, Intergovernmental
CommBVCOG
❑ Gary Arnold, Intergovernmental
Comm/Brazos County Sheriff
❑ Gary Testdn, Intergovernmental
Co Ea4terwood Airport
ONE
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
Ilhane ❑ Ben White ZONE
❑ Lynn Mc y
Brazos Valley Council of
Governments
O Ron Silvia, Mayor NE
B/CS Metropolitan Planning
Organization
O Ron Silvia, Mayor SZNIcINIE
BVCOG TMPA Regional Park
Project Advisory Board
O Lynn Mcllhaney N'116NE
BVSWMA Policy Advisory
Board
O Ron Silvia, Mayor 0 Chris ScottiO/NE
❑ Ro)Silvia
'I ONE
❑ Ron Gay
glA(ONE
City Center Committee
❑ Ben White
Intergovernmental Committee
❑ Dave Ruesintic
❑ Ben White 0 John Happ
❑ D e Ruesink
ONE
O Dave Ruesink
❑ Ron Gay
O Ken Fogle
O Michael Parker, BVCOG
❑ Ron Gay
❑ John Nichols
❑ Joan Perry
Joint City/School
Intergovernmental Committee
❑ Ben White ❑ John Ha
Sister Cities Association
ONE
Transportation Committee
❑ John Happ
❑ Linda LaSuit, MPO
El Bryan Woods, TxDOT
Wolf Pen Creek Oversight
Committee
❑ Chris Scotti
❑ Marsha Sanford
❑ Sharon Colson
P
El Lynn Mc�Ilhaney
❑ Dennis Christianson, TTI
g)tolv--;
❑ Marc Chaloupka
❑ Jour Warner
ONE
Describe each affiliation or business relationship with an employee checked in Question 4 above:
\,0e
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 lobal governmental
entity?
Yes
No
C. Is the filer of this questionnaire affiliated with a corporation or other business entity thitt 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.
c&A,
:\j,
k4110
Signature of person doing business with the governmental entity
-S `G7
Date
Adopted 01/13/06