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Plant Equipment Services, Inc. - UpdateCONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity FORM CIQ 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. 2. OFFICE USE ONLY Date Received Plar VA v14 setvje s 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. O David Massey, Electric ❑ Lance Simms, Planning & Dev O 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. Olivia Burnside, Inf. Tech. Michael Clancey, Police Chief Jeff Kersten, Chief Fin.Officer Julie O'Connell, Human Resources Ed Spillane, Municipal Judge 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 College Station Elected Officials College Station City Council ❑ Ben White, Place 1 ❑ nn Mcllhaney, Place 4 GONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Jennifer Bohac ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ S ve Parker, alternate I NNONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ Rp Slocum E NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Schen ❑ B. Carroll Johnson NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑Ernie Wright VNONE ❑ Rebecca Eplen ❑ Rusleen Maurice ONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton NONE El John Nichols, Chair ❑ Marsha Sanford O Harold Strong Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne El Charlotte Mikulee Parks and Recreation Board ❑ Kathleen Ireland O Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen NONE Design Review Board ❑ Marguerite Anthony O Meredith Waller El Colleen Risinger ❑ Deborah Deitering O Peggy Samson ❑ Joan Perry El Gary Thomas O Gary Erwin ❑ Derek Dictson ❑ Bill Davis O Rick Heany 0 Hunter Goodwin 0 Nancy Sawtelle ❑ Alan King 0 Ward Wells 0 John Nichols O Susie Cox, alternate 0 Robert Rayburn, alternate (TONE ❑ Jay Goss, Chair ❑ nise Whisenant NNE Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones ❑ Stephen Syptak, Chair O Tom Kirkland Q4VONE O Hugh Lindsay, Area I O John Crompton, Area II O Steve Arden, Area III O Hugh Stearns, Area IV O Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember O Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ //Larry Mariott [IYNONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review O Charles Taylor O Sheryl Welford kNONE Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large ❑ Lynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman ❑ Marc Chaloupka rjy1GONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson O Dale O'Riley ❑ David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area II ❑ Tom Taylor, Alternate, Area III O 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 ❑ 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 O Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce O 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 Cornm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport (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 ❑ Lynn Mcllhaney ❑ Ben White 'NONE Brazos Valley Council of Governments O Ron Silvia, Mayor /NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor /NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Lynn Mcllhaney JNONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti EIXO-NE City Center Committee O Ron Silvia 0 Ben White 0 Dave Ruesink Ii ONE Intergovernmental Committee 0 Ben White 0 John Happ ❑ RnGay INTONE ❑ Dave Ruesink ONE Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association ❑ Dave Ruesink (NONE Transportation Committee ❑ Ron Gay ❑ John Happ 0 Lynn Mcllhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT V<ONE 0 Ron Gay Wolf Pen Creek Oversight Committee 0 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 FORM CIQ This section, item 5 including subparts A, B, C & D, must be completed for each o has affiliation or other relationship. Attach additional pages to this Form CIQ as nec fficer with whom the filer essary. 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. buktuolo Si ature of person doing business with the governmental entity Plazz /'. Seralezpv2-nC M 7 Date Adopted 01/13/06 20066 3:19 AM GWFAX -) 9797798400 CONFLICT OF INTEREST QUESTIONNAIRE For vendo r or other person doing business with local governmental entity This questi pnnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law thi' 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, L)cal Government Code. A person ccmmitts an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. Page 22 of 69 FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 2. Check this box if you are filing an update to a previously filed questionnaire. (rhe law requires that you file an updated completed questionnaire with the appropriate Bing authority not later than September 1 of the year for which an activity described in Section 176.006(a), Local Gov ment Code, is pending and not later tha l the 7th business day after the date the originally filed questionnaire becomesimincomplete or inaccurate.) 3. Describe each affiliation or business relationship with an employee or contractor of the local governmetital entity who makes recommendations to a local government officer of the local governmental entity win respect to expenditure of money. ❑ Robert Alley, Fire Chief ❑ Steve Thachy, Parks & Rec El Glenn Frown, City Manager ❑ Olivia Eturnside, inf. Tech. ❑ Pete Ca er, Landfill Mgr. Cl Harvey Cargill, City Attorney 1-1 John W )ody, Utilities ❑ Michael Clancey, Police Chief El Joey Dunn, Planning & Dev El Don Fazzino, Legislative Liason E l Charles Wood, Economic Dev El Connie Hooks, City Secretary El Jeff Kersten, Finance DONE El Ch les McLemore, Public Works ❑ Be ky Nugent, Public Relations ❑ Jul e O'Connell, Human Resources ❑ M rk Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Chryl Turney, Purchasing Mgr. Describe each affiliation or business relationship with an employee checked in Question 3 above: 15/2006 9:19 AM GWFA% -> 9797798400 Page 23 of 69 4. Describe each affiliation or business relationship with a person who is a to .al government officer and IA he; appoints or employs a local government officer of the local government ntity that is the subject of this questi tnnaire, City of College Station Elected Officials College Station City Council El Ron Silvia, Mayor ❑ Ben White, Place 1 El Ron Ga j, Place 3 ❑ Susan Lancaster, Place 4 ❑ Nancy Berry, Place 6 VNONE ❑ Jo Happ, Place 2 ❑ Cl ris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee El Larry Ringer, Chairman ❑ Katherine Edwards ❑ D n Scherr ❑ Eric Mi ler ❑ Jeanne Mitchell ❑ Jo erg ❑ Lois Kcontz ❑ James Bradford NE Cemetery Committee ❑ Sarah A dams, Chair ❑ Virginia Reese ❑ James Eatenhorst ❑ Mary Lind Bryan ❑ David Chester ONE ❑ Dan B. ;ears, Chairman ❑ Mike Lune ❑ Steve Parker, alternate ❑ Karen Kasper, Merchant El ey Dt nn, Dir. Planning & Dcv WNN ONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair ❑ Larry D. Patton ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Kelvin Myers ❑ Jo: Wallace ❑ F . nk Cox ❑ Da id Hart, alternate ❑ Valerian Miranda, Architect ❑ Rik Lemmons, Business Owner ❑ Robert Mosley, City Engineer ❑ Eri Barton, CD Coordinator 15/2006 9:19 AM GWFAX -> 9797798400 El Hillary .fessup, Chairman ❑ Margue-ite Anthony ❑ Thomas Taylor ❑ Colleen Risinger El Rebecca Eplen ❑ sleen Maurice NONE ❑ KathlcciIreland El Carol Blaschke ❑ n Crampton ONE ❑ Scott Shafer, Chairman ❑ Marsha Sanford ❑ Harold Strong ❑ Rick He any ❑ Alan King ❑ Susie C•)x, alternate 1-7 Jay Goss, Chair ❑ Graham Sheffy El Denise Whisenant Historic Preservation Committee E l Bill Lancaster El David Ruesink ❑ Ernie Wright 7 ONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board El Glenn Schroeder O Jeannie McCandless ❑ Harry Green Planning and Zoning Commission El John Nichols ❑ //Dennis Christiansen NONE Design Review Board ❑ Hunter Goodwin El Ward Wells 0 Robert Rayburn, alternate Zoning Board of Adjustments El Joshua Benn ❑ Donald Braune ❑ Derek Dictson Page 24 of 69 ❑ Mtrsha Crenwelge ❑ Di,ankar Sen El N: al Nutall, Jr. ❑ M Sherwood 0 Pe:gy Samson ❑ l Jo 4i Warner ❑ Gay Thomas ❑ G Ilaky Erwin ❑ Ke i Reynolds ❑ Bil Davis ❑ Nancy Sawtelle ❑ Sectt Shafer 12NONE ❑ Joh 0 5h� LSI NO Richards les Taylor IE 15/2006 9: 19 AM GWFAX -> 9797798400 Research Valley Partnership Board of Directors ❑ David Hickson El Larry Mariott ❑ Glenn Erown, City Manager {NONE El Sharon 'Colson, Chair El Kenny Mallard Wolf Pen Creek TEF Board ❑ Marsha Sanford, Vice Chair El James Massey ❑C Page 25 of 69 is Scotti, Councilman ❑OM rc Chaloupka Ed NdNE The following individuals are appointed by the City Council to represent the of College Station on joint committees with other governmental agencies and community groups. ❑ Susan I_ ancaster ❑ Ron Silvia, Mayor El Ron Sil ria, Mayor ❑ Susan Lancaster 0 Ron Silvia, Mayor Brazos County Health Department 0 Nancy Berry Brazos Valley Council of Governments Board of Directors ❑/1 LONE B/CS Metropolitan Planning Organization GONE BVCOG TMPA Regional Park Project Advisory Board NE BVSWMA Policy Advisory Board 0 Susan Lancaster U ]_•�) AM fl on Si!Sit zia [ NONE GWFAX -> 9797798400 Page 26 of 69 City Center Committee ❑ Ben White ❑ N Intergovernmental Committee ❑ Nancy Berry 0 Ben White ❑/NONE ❑ ncy Berry El Joint City/School Intergovernmental Committee 0 Ben White Sister Cities Association O Ron Gay EJONE O Ron Ga 9 O Linda LaSuit, MPO O Bryan Woods, TxDOT Transportation Committee ❑ John Happ 0 De nis Christianson, TTI ONE ❑ Jo cy Berry n Happ ❑ John Happ El Ken Fogle El Michael Parker, BVCOG 1 Wolf Pen Creek Oversight Committee r ❑ Chris Scotti k7'NONE ■Ron Gay Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01 /13/06 '2006 9:19 AM GWFAX -> 9797798400 CONFLICT OF INTEREST QUESTIONNAIRE For vendo r or other person doing business with local governmental entity Page 27 of 69 FORM CIQ This sectio i, item 5 including subparts A, B, C & D, must be completed for each fficer with whom the filer has affiliation or other relationship. Attach additional pages to this Form CIQ as n essary. 5. Name of local government officer with whom filer has affiliation or busine s 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 rece ve taxable income from the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income fro jm or at the direction of the local government officer named in this section AND the taxable income is not fror}i the local governmental entity? II Yes No C. Is the filer of this questionnaire affiliated with a corporation or other business Cl government officer serves as an officer or director, or holds an ownership of 10 pe Yes No D. Describe, each affiliation or business relationship. 6. tity that the local cent or more? Sign at ire of person doing business with the governmental entity Date Adopted 01/13/06