Brazos PavingCONFLICT OF INTEREST QUE'TIONNAIRE
For vendor or other person doing busine s with local governmental entity
FORM CIQ
OFFICE USE ONLY
This questionnaire is being filed in accorda ce with chapter 176 of the Local
Government Code by a person doing busin...s with the governmental entity.
By law this questionnaire must be filed wit the records administrator of the
local government not later than the 7th busi ess 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 iolates Section 176.006, Local
Government Code. An offense under this se tion is a Class C misdemeanor.
Date Received
1. Name of person doing business with lo al governmental entity.
2.
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated comp eted 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 reel_-____ _.
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
❑ Lance Simms, Planning & Dev
Cl Cheryl Turney, Purchasing Mgr.
❑ Terry Childers, Deputy City Mgr
❑ Steve Beachy, Parks & Rec
❑ Harvey Cargill, City Attorney
❑ Coinie Hooks, City Secretary
O Becky Nugent, Public Relations
❑ Mark Smith, Public Works
❑ John Woody, W/WW
❑ Kathy Merrill, Asst. City Mgr.
❑ Olivia Burnside, Inf. Tech.
❑ Michael Clancey, Police Chief
❑ Jeff Kersten, Chief Fin.Officer
❑ Julie O'Connell, Human Resources
❑ Ed Spillane, Municipal Judge
xi 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.
❑ Ron Silvia, Mayor
❑ Ron Gay, Place 3
❑ David Ruesink, Place 6
City of ollege Station Elected Officials
C
II
lege Station City Council
❑ B.n White, Place I
❑ L nn Mcllhaney, Place 4
TAN NE
0
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
City of College Stat on Committees, Boards, and Commissions
CS Library Committee
❑ Larry Ringer, Chairman ❑ K. herine Edwards 0 Don Scherr
❑ Mary Fran Troy ❑ Je nne Mitchell 0 B. Carroll Johnson
O Sonio Margarita Gangotena ❑ Ja es Bradford ial NONE
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
O Donald Braune
❑ Dan B. Sears, Chairman
❑ Mike Lane
❑ Steve Parker, alternate
►2
NONE
❑ Vi
❑ W
0
11 N
0
I
Cemetery Committee
ginia Reese 0 Kevin Myers
]don Kruger 0 Joe Wallace
Slocum ❑ James Matson
NE
onstruction Board of
Adjustments and
App alsBuilding & Standards
Commission
❑ Fr. k Cox ❑ David Hart
❑ L. D. Patton ❑ Charles Thomas, alternate
O GI nn Thomas, alternate ❑ Quinn Williams
❑ Hillary Jessup, Chairman
❑ Haskell Monroe
❑ Ernie Wright
'133 NONE
❑ Tedi Ellison
❑ Rusleen Maurice
12} NONE
O Jodi Warner, Chair
❑ Shawn Rhodes
O John Crompton
PI NONE
❑ John Nichols, Chair
O Marsha Sanford
❑ Harold Strong
❑ Rick Heaney
❑ Alan King
❑ Susie Cox, alternate
❑ Jay Goss, Chair
❑ Denise Whisenant
O NONE
Hist s ric Preservation Committee
❑ Bi 1 Lancaster
❑ Ja e Hughey
❑ N.al Nutall, Jr.
Jo nt Relief Funding Review
Committee
❑ J.
❑ R
❑ Marguerite Anthony
❑ Meredith Waller
❑ Colleen Risinger
evin Byrne ❑ Deborah Deitering
a Ragdale 0
Pa ks and Recreation Board
❑ K. hleen Ireland 0 Joan Perry
❑ Jo y Ford 0 Gary Thomas
❑ H. Green ❑ Gary Erwin
Planning and Zoning
Commission
❑ GI; nn Schroeder ❑ Derek Dictson
❑ De nis Christiansen ❑ Bill Davis
❑ NONE
Design Review Board
❑ Hu ter Goodwin 0 Nancy Sawtelle
❑ W.rd Wells ❑ John Nichols
❑ Ro ert Rayburn, alternate NONE
Zon ng Board of Adjustments
❑ Jos ua Benn
❑ Do ald Braune
❑ John Richards
❑ Thomas Mather
❑ Larry Hodges
❑ Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
❑ Don Lewis
❑ Gregg Baird
❑ Chad Jones
❑ Stephen Syptak, Chair
❑ Tom Kirkland
® NONE
❑ Hugh Lindsay, Area I
❑ John Crompton, Area II
❑ Steve Arden, Area Ill
❑ Hugh Stearns, Area IV
❑ Andrew Burleson, Student Resident
❑ Dorthea Robinson, Alternate,
ETJ Resident
❑ Chris Scotti, Councilmember
❑ Hillary Jessup, Historic
Preservation
❑ Lloyd Wasserman, County
Commission
Re.earch Valley Partnership
Board of Directors
❑ L • ry Mariott
NONE
If Pen Creek TIF Board
❑ Marsha Sanford, Vice Chair
❑ Ja es Massey
Outs de Agency Funding Review
❑ Ch rles Taylor
O Sh ryl Welford
®N NE
N i rthgate Tax Increment
Finance Board
O Da id Scarmardo
O GI nn Thomas
Com i rehensive Plan Committee
❑ Joh Richards, Area I
O Bri n Bochner, Area II
❑ La ie Corbelli, Area III
❑ Jer , Cooper, Area IV
O Kri'tina Campbell, Alternate,
Stu'ent Resident
❑ Cra g Hall, Resident -At -Large
❑ Lyn Mcllhaney, Alternate,
Co ncilmember
❑ G • Erwin, Parks & Rec
❑ La , Haskins, Northgate
Dist ict Assoc.
❑ Chris Scotti, Councilman
❑ Marc Chaloupka
lS1 NONE
❑ Roger Reese
❑ Carolyn Berrow
❑ Anne Jackson
Cl Dale O'Reiley
❑ David Hart, Alternate, Area I
❑ Dennis Corrington, Alternate, Area 11
❑ Tom Taylor, Alternate, Area IlI
❑ Adrian Williams, Alternate. Area iv
❑ Douglas Rape', ETJ Resident
❑ Mike Guido, Alternate,
Resident -At -Large
❑ Bill Davis, P&Z
❑ Kathleen Ireland, Parks & Rec
Alternate
El Bo Miles, Building & Land
Development
❑ Larry Marriott, Home Builders
Assoc.
O Tedi Ellison, Intergovernmental
Comm/Chamber of Commerce
❑ James Massey, Intergovernmental
Comm/TAMU Admin
❑ Li da LaSut, Intergovernmental
C
m/MPO
❑ Li dsey Guindi, Intergovernmental
Co m/Chamber of Commerce
❑ R•dney Weis, Intergovernmental
Co m/TAMU Transit
❑ Dr. Clark Ealy, Intergovernmental ❑ Dr
Comm/CSISD In
❑ Chuck Martinez,
Intergovernmental Comm/
Research Valley Patnership
❑ M
In
Br
Colleen Netterville,
rgovernmental Comm/BISD
rgie Lucas,
rgovernmental Comm/
os Transit District
❑ Chad Bohne, Intergovernmental
Comm/TxDOT
❑ Michael Parks, Intergovernmental
Comm/BVCOG
❑ Gary Arnold, Intergovernmental
Comm/Brazos County Sheriff
❑ Gary Teston, Intergovernmental
Comm/ Easterwood Airport
® NONE
The following individuals are appointed ' y the City Council to represent the City of College Station on
joint committees with other governmenta agencies and community groups.
❑ Lynn Mcllhaney
❑ Ron Silvia, Mayor
❑ Ron Silvia, Mayor
❑ Lynn Mcllhaney
❑ Ron Silvia, Mayor
❑ Ron Silvia
• NONE
❑ Ron Gay
21 NONE
Brazos County Health
Department
❑ Be White ® NONE
N
razos Valley Council of
Governments
NE
B/ 1 S Metropolitan Planning
Organization
• N
Ii
NE
BV 1 OG TMPA Regional Park
' roject Advisory Board
• NINE
B ' SWMA Policy Advisory
Board
❑ Ch is Scotti
ity Center Committee
❑ Be White
Inte governmental Committee
❑ Be White
•Lil NONE
❑ Dave Ruesink
❑ John Happ
❑ Dave Ruesink
IE1 NONE
Joint City/School
Intergovernmental Committee
❑ Ben White ❑ John Happ
Sister Cities Association
❑ Dave Ruesink NONE
Transportation Committee
❑ Ron Gay ❑ John Happ ❑ Lynn McIlhaney
❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI
❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT p NONE
❑ Ron Gay
❑ John Nichols
❑ Joan Perry
Wolf Pen Creek Oversight
Committee
❑ Chris Scotti
❑ Marsha Sanford
❑ Sharon Colson
❑ Marc Chaloupka
❑ Jodi Warner
51) NONE
Describe each affiliation or business relationship with an employee checked in Question 4 above:
NO.'"NC_
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 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 person doing business with the governmental entity
6A/0 7
Date
Adopted 01/13/06