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Dudley Construction, LtdCONFLICT 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. 1�i�RK floc Ey - Piesioaui— cP plo ,AfoP piezm►a/e- 2. �uTUN Op. 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 O Bob Cowell, Planning & Dev O Cheryl Turney, Purchasing Mgr. O Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney O Connie Hooks, City Secretary ❑ Becky Nugent, Public Relations ❑ Mark Smith, Public Works O Dave Coleman, W/WW ❑ Kathy Merrill, Asst. City Mgr. O Ben Roper, Inf. Tech. O Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer O Julie O'Connell, Human Resources O Ed Spillane, Municipal Judge ONE 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 ❑ Ben White, Mayor 0 John Compton, Place 1 O Ron Gay, Place 3 0 L, Mcllhaney, Place 4 O David Ruesink, Place 6 n NONE O James Massey, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman O Mike Lane ❑ St a Parker, alternate ONE B/CS Library Committee ❑ Katherine Edwards 0 Don Scherr O Jeanne Mitchell 0 B Carroll Johnson ❑ James Bradford Q'NONE Cemetery Committee ❑ Virginia Reese O Weldon Kruger ❑ RC Slocum Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton O Glenn Thomas, alternate ❑ Kevin Myers ❑ Joe Wallace O James Matson O David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman O Haskell Monroe ❑ EiellsTright • ONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger O Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering O Rygreen Maurice 0 Reba Ragdale 0 NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ J9M. Crompton NONE O John Nichols, Chair O Marsha Sanford ❑ Harold Strong ❑ Rick Heaney O Alan King O Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green ❑ Joan Perry O Gary Thomas ❑ Gary Erwin Planning and Zoning Commission O Glenn Schroeder 0 Derek Dictson O De Christiansen 0 Bill Davis ONE Design Review Board ❑ Hunter Goodwin 0 Nancy Sawtelle O Ward Wells 0 John Nichols O Robert Rayburn, alternate ■ •NE Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune O John Richards O Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ '99m Kirkland L"NONE ❑ Hugh Lindsay, Area I ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ L� Mariott COY NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor O ryl Welford NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ Laurie Corbelli, Area III O Jerry Cooper, Area IV O 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 ❑ M Chaloupka V4 ONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ 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 ❑ Larry Marriott, Home Builders Assoc. O Tedi Ellison, Intergovernmental Comm/Chamber of Commerce 0 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 CommBISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental CommBVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Co m/ Easterwood 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 O Lynn Mcllhaney 0 Ben White NONE Brazos Valley Council of Governments O Mayor NONE B/CS Metropolitan Planning Organization O Mayor NONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney ONE BVSWMA Policy Advisory Board O Mayor ❑ Chris Scotti ONE City Center Committee O n Silvia 0 Ben White 0 Dave Ruesink WINONE Intergovernmental Committee O 3.dn Gay 0 Ben White 0 John Happ I NONE • ve Ruesink NONE Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association 0 Dave Ruesink N}NONE Transportation Committee O Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 Dynis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT i71ONE O Ron Gay O John Nichols O Joan Perry Wolf Pen Creek Oversight Committee O Chris Scotti O Marsha Sanford O Sharon Colson O Marc Chaloupka O Jodi Warner NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. 1\) j P 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 of person doing business with the governme tal entity 9 -d 5-D'7 Date Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ 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. Who Pw -Pa Es •0 r. Vic. 6P _ 0,41e 2. OFFICE USE ONLY Date Received SEP 2 0 2007 Cens� c. #i ov 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. O David Gwin, Economic Dev. O David Massey, Electric ❑ Bob Cowell, Planning & Dev O Cheryl Turney, Purchasing Mgr. O Terry Childers, Deputy City Mgr O Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ Dave Coleman, W/WW O Kathy Merrill, Asst. City Mgr. O Ben Roper, Inf. Tech. O Michael Clancey, Police Chief O Jeff Kersten, Chief Fin.Officer O Julie O'Connell, Human Resources 011 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. ❑ Ben White, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council O John Compton, Place 1 O Lynn Mcllhaney, Place 4 IW ONE O James Massey, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonia Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane 0 eve Parker, alternate NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell O James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ Slocum NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate ❑ Don Scherr O B> arroll Johnson ( ONE O Kevin Myers O Joe Wallace O James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Einie Wright V6ONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger O Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering ❑ ye6sleen Maurice 0 Reba Ragdale ❑ FIVNONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ ohn Crompton NONE O John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong Parks and Recreation Board O Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission O Joan Perry O Gary Thomas O Gary Erwin O Glenn Schroeder 0 Derek Dictson is Christiansen 0 Bill Davis Design Review Board ❑ Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle O Alan King 0 Ward Wells 0 Jo Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate ONE ❑ Jay Goss, Chair 0 penise Whisenant ONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O John Richards O Thomas Mather ❑ Larry Hodges O Glenn Brown, City Manager ❑ Sharon Colson, Chair O Kenny Mallard ❑ Don Lewis ❑ Gregg Baird O Chad Jones O Stephen Syptak, Chair O Tom Kirkland NONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV O Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ eryl Welford NONE Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. 0 Chris Scotti, Councilman ❑ Nc Chaloupka ONE ❑ Roger Reese O Carolyn Berrow ❑ Anne Jackson O Dale O'Reiley ❑ David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area II ❑ Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident ❑ Mike Guido, Alternate, Resident -At -Large O Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate O 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 O 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 O Dr. Colleen Netterville, Intergovernmental CommBISD O Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental mm/ Easterwood Airport ZONE 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 0 Lynn Mcllhaney 0 Ben WhiteNONE Brazos Valley Council of Governments O Mayor &ZONE B/CS Metropolitan Planning Organization O Mayor NONE BVCOG TMPA Regional Park P ject Advisory Board O Lynn Mcllhaney NONE BVSWMA Policy Advisory Board ❑ Mayor ❑ Chris Scotti NIZNE City Center Committee ❑ on Silvia 0 Ben White 0 Dave Ruesink NONE Intergovernmental Committee ❑ on Gay 0 Ben White 0 John Happ NONE O 1944ve Ruesink IL/NONE O Dave Ruesink O Ron Gay O Ken Fogle O Michael Parker, BVCOG O Ron Gay O John Nichols O Joan Perry Joint City/School Intergovernmental Committee O Ben White 0 John Happ / S. er Cities Association ONE Transportation Committee O John Happ O Linda LaSuit, MPO O Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee O Chris Scotti O Marsha Sanford O Sharon Colson O Lynn Mcllhaney O De 's Christianson, TTI O Marc Chaloupka O Jydi Warner Et/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. ri I P` 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. MARK 'tk,tuey - P t oP n4 6- 6 Signature of person doing business with the g• - • ental entity Date SEy-r• I g, Zoo -7 Adopted 01/13/06 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. Dtattitr_ ,Ceetat PatheithiP - 2. 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 Glenn Brown, City Manager O Robert Alley, Fire Chief O Pete Caler, Landfill Mgr. O David Gwin, Economic Dev. O David Massey, Electric O Bob Cowell, Planning & Dev o Cheryl Turney, Purchasing Mgr. O Terry Childers, Deputy City Mgr O Steve Beachy, Parks & Rec O Harvey Cargill, City Attorney O Connie Hooks, City Secretary O Becky Nugent, Public Relations O Mark Smith, Public Works O Dave Coleman, W/WW O Kathy Merrill, Asst. City Mgr. O Ben Roper, Inf. Tech. O Michael Clancey, Police Chief O Jeff Kersten, Chief Fin.Officer O Julie O'Connell, Human Resources O 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. City of College Station Elected Officials College Station City Council O Ben White, Mayor 0 OPEN, Place 1 0 Ron Gay, Place 3 0 Jynn Mcllhaney, Place 4 O David Ruesink, Place 6 NONE O James Massey, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Sonio Margarita Gangotena O Sarah Adams, Chair O James Batenhorst O David Chester O Donald Braune O Dan B. Sears, Chairman O Mike Lane ke 0 teve Parker, alternate NONE B/CS Library Committee O Katherine Edwards 0 Don Scherr O Jeanne Mitchell 0 B. Carroll Johnson O James Bradford ONE Cemetery Committee O Virginia Reese O Weldon Kruger O R, -Slocum BeNONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate O Kevin Myers O Joe Wallace O James Matson o David Hart o Charles Thomas, alternate O Quinn Williams O Hillary Jessup, Chairman O Haskell Monroe O rnie Wright 14 NONE Historic Preservation Committee O Bill Lancaster O Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee O Marguerite Anthony O Meredith Waller O Colleen Risinger O Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering 0 7usleen Maurice 0 Reba Ragdale 0 te NONE O Jodi Warner, Chair O Shawn Rhodes Olohn Crompton 44 NONE O John Nichols, Chair O Marsha Sanford O Harold Strong Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission O Glenn Schroeder O Dennis Christiansen NONE Design Review Board O Joan Perry O Gary Thomas O Gary Erwin O Derek Dictson O Bill Davis 0 Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle O Alan King 0 Ward Wells 0 John Nichols O Susie Cox, alternate 0 Robert Rayburn, alternate NONE O Jay Goss, Chair 0/Denise Whisenant 6 NONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O John Richards O Thomas Mather O Larry Hodges O Glenn Brown, City Manager O Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones O Stephen Syptak, Chair O Tom Kirkland III/NONE 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 O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember O Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors Larry Marion NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review O Charles Taylor O Sheryl Welford "NONE Northgate Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II O Laurie Corbelli, Area III O Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec O Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman O Marc Chaloupka CiNONE O Roger Reese O Carolyn Berrow O Anne Jackson O Dale O'Reiley O David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area II O Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident O Mike Guido, Alternate, Resident -At -Large O Bill Davis, P&Z O Kathleen Ireland, Parks & Rec Alternate O Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce O James Massey, Intergovernmental Comm/TAMU Admin ❑ Dr. Clark Ealy, Intergovernmental Comm/CSISD O 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 CommBISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff O Gary Teston, Intergovernmental omm/ Easterwood Airport iNONE 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 O Lynn McllhaneY 0 Ben White NONE Brazos Valley Council of Governments O Mayor NONE B/CS Metropolitan Planning Organization O Mayor NONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney H NONE BVSWMA Policy Advisory Board / O Mayor 0 Chris Scotti [ NONE City Center Committee 0/Ron Silvia 0 Ben White 0 Dave Ruesink ® NONE Intergovernmental Committee O Ron Gay 0 Ben White 0 John Happ d NONE ❑ Dave Ruesink Eli NONE 0 Dave Ruesink Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association 'NONE Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT E/NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee O Chris Scotti O Marsha Sanford O Sharon Colson ❑ Marc Chaloupka 0/ Jodi Warner Al 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 or business relationship. 6. Signature of person doing business w overnmental entity Date Adopted 01/13/06 CERTIFICATION CERTIFICATION OF BID The undersigned affirms that they are duly authorized to execute this contract, that this bid has not been prepared in collusion with any other bidder, and that the contents of this bid have not been communicated to any other bidder prior to the official opening of this bid. Additionally, the undersigned affirms that they firm is willing to sign the enclosed Standard Form of Agreement (if applicable). Signed By:l‘/ Title: gaga* � � Cwa.Par - Typed Name: blot Patti ompany Name: Polk( C rtSfruch on I LJd. Phone No.:I 9iq-776.213,E Fax No.: q79-776-Z.Z3S' Email: Ind Ud (ett of'/M1'1 dar Irfitictioi . aw) Bid Address: 1/5 70 SH 30CS TX 770cfr P.O. Box or Street City State Zip Order Address: t rh.2 _ P.O. Box or Street City State Zip Remit Address: ' ti P.O. Box or Street City State Zip Federal Tax ID No.: g 1- oS ,%S4 Date: Scp- . (l a Zoo? Number of Addenda Received: END OF BID #07-117 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. affner (Ncile.A.( ConsiruthoA G -td) 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 ❑ John Woody, W/WW O Kathy Merrill, Asst. City Mgr. O Ben Roper, Inf. Tech. O Michael Clancey, Police Chief O Jeff Kersten, Chief Fin.Officer O Julie O'Connell, Human Resources ❑ )fid 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. City of College Station Elected Officials College Station City Council ❑ Ben White, Mayor 0 OPEN, Place 1 O Ron Gay, Place 3 0 7ynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 . NONE ❑ James Massey, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman O Mary Fran Troy O Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester O Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ St e Parker, alternate ONE B/CS Library Committee O Katherine Edwards 0 Don Scherr O Jeanne Mitchell �❑ B. Carroll Johnson O James Bradford C3NONE Cemetery Committee O Virginia Reese O Weldon Kruger O RCS cum ONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate O Kevin Myers ❑ Joe Wallace O James Matson O David Hart O Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ E ie Wright l NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne 0 Deborah Deitering ❑ Rtpen Maurice ❑ Reba Ragdale 0 'NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ John Nichols, Chair ❑ Glenn Schroeder ❑ Marsha Sanford ❑ Dennis Christiansen ❑ Harold Strong ONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heaney ❑ Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King ❑ Ward Wells John Nichols ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate ONE ❑ Jay Goss, Chair ❑ Denise Whisenant fa74NE 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 ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland {.2'gTONE ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Mariott CONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ SherylylWelford 8'NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ 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 ❑ __Marc '�Chaloupka L2YIVN�, ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ 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 ❑ 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 O Michael Parks, Intergovernmental Comm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood 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 O Lynn Mcllhaney 0 Ben White ®'NONE Brazos Valley Council of Governments O MayorONE B/CS Metropolitan Planning 0 ganization O Mayor ONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney ■ ' ONE BVSWMA Policy Advisory Board O Mayor 0 Chris ScottiONE City Center Committee O Ron S' . 0 Ben White 0 Dave Ruesink ONE Intergovernmental Committee 0 Ron G ONE 0 Ben White 0 John Happ O Dave Ruesink E Joint City/School Intergovernmental Committee 0 Ben White Sister Cities Association O Dave Ruesink ONE Transportation Committee 0 John Happ ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO 0 Dene Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT CLONE O Ron Gay ❑ John Nichols O Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti O Marsha Sanford O Sharon Colson ❑ Marc Chaloupka O Jodi Warner ONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. 01A - 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 o pers . doing business .30; 2oal the governmental entity Date Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ 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. 2. da dgainRAL F--Fc1ZTi•IERS1-11 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. ❑ 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. O Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec O Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ Ed Spillane, Municipal Judge C1 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. O Ben White, Mayor O Ron Gay, Place 3 0 David Ruesink, Place 6 City of College Station Elected Officials College Station City Council 0 OPEN, Place 1 O Lynn Mcllhaney, Place 4 E(NONE O James Massey, Place 2 El Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Sonio Margarita Gangotena O Sarah Adams, Chair O James Batenhorst O David Chester O Donald Braune El Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate NONE B/CS Library Committee O Katherine Edwards O Jeanne Mitchell O James Bradford Cemetery Committee O Virginia Reese O Weldon Kruger O RC Slocum GI/NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate O Don Scherr O B. Carroll Johnson 'NONE O Kevin Myers O Joe Wallace O James Matson El David Hart O Charles Thomas, alternate O Quinn Williams LI Hillary Jessup, Chairman O Haskell Monroe El Ernie Wright Ed NONE Historic Preservation Committee O Bill Lancaster O Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee O Marguerite Anthony O Meredith Waller O Colleen Risinger O Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering O Rusleen Maurice 0 Reba Ragdale 0 i NONE O Jodi Warner, Chair O Shawn Rhodes O John Crompton g NONE O John Nichols, Chair O Marsha Sanford O Harold Strong Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission O Glenn Schroeder O Dennis Christiansen IRI(NONE Design Review Board O Joan Perry O Gary Thomas O Gary Erwin O Derek Dictson O Bill Davis O Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle O Alan King 0 Ward Wells 0 John Nichols O Susie Cox, alternate 0 Robert Rayburn, alternate Er NONE O Jay Goss, Chair O Denise Whisenant 1?1 NONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O John Richards O Thomas Mather El Larry Hodges O Glenn Brown, City Manager O Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones O Stephen Syptak, Chair O Tom Kirkland d NONE 0 Hugh Lindsay, Area I O John Crompton, Area II O Steve Arden, Area III O Hugh Stearns, Area IV O Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember 0 Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors O Larry Mariott Ef NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review O Charles Taylor O Sheryl Welford 2' NONE Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II O Laurie Corbelli, Area Ill El Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec O Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman 0 Marc Chaloupka g NONE O Roger Reese El Carolyn Berrow O Anne Jackson O Dale O'Reiley O David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area 11 0 Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area [V El Douglas Rape', ETJ Resident 0 Mike Guido, Alternate, Resident -At -Large El Bill Davis, P&Z O Kathleen Ireland, Parks & Rec Alternate O Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ James Massey, Intergovernmental Comm/TAMU Admin El 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/B1SD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District 0 Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental CommBVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport C3'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 12' NONE Brazos Valley Council of Governments ❑ Mayor N NONE B/CS Metropolitan Planning Organization ❑ Mayor iNONE BVCOG TMPA Regional Park Project Advisory Board ❑ Lynn Mcllhaney NI7NONE BVSWMA Policy Advisory Board ❑ Mayor ❑ Chris Scotti ErNONE City Center Committee ❑ Ron Silvia ❑ Ben White 0 Dave Ruesink NONE Intergovernmental Committee ❑ Ron Gay ❑ Ben White 0 John Happ Er NONE ❑ Dave Ruesink NONE O Dave Ruesink Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association IE/ NONE Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT ErNONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford O Sharon Colson O Marc Chaloupka ❑ Jodi Warner NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. N /A 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. ,E Li/OF MhrtK�uri�e-•P¢esiDe�T `1 &V esafe- fl mJSH, p Signature of person doing business wi , the governmental entity 7ku6-7115T q, 2DO7 Date Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. }AARK -IxID— lizr cr( E e-t'>;I 1p 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 O Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works O John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ Ed Spillane, Municipal Judge Pr 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. ❑ Ben White, Mayor ❑ Ron Gay, Place 3 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ OPEN, Place 1 ❑ Lynn Mcllhaney, Place 4 ID/NONE ❑ James Massey, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman O Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair O James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane 01Steve Parker, alternate NONE B/CS Library Committee O Katherine Edwards ❑ Jeanne Mitchell O James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger 0 R Slocum E/NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox O Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr O B. Carroll Johnson El/NONE ❑ Kevin Myers ❑ Joe Wallace O James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman O Haskell Monroe ❑ Ernie Wright lg NONE Historic Preservation Committee ❑ Bill Lancaster O Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony Cl Meredith Waller O Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering O Rusleen Maurice ❑ Reba Ragdale 0 El/NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes O John Crompton 11 NONE ❑ John Nichols, Chair O Marsha Sanford O Harold Strong Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford O Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen G2 NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin O Derek Dictson O Bill Davis ❑ Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle ❑ Alan King 0 Ward Wells 0 John Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate C3"NONE ❑ Jay Goss, Chair ❑ Denise Whisenant E /NONE Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard O Don Lewis O Gregg Baird ❑ Chad Jones O Stephen Syptak, Chair O Tom Kirkland G✓NONE ❑ Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember O Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors O Larry Mariott IINONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford IdNONE 0 Chris Scotti, Councilman ❑ Marc Chaloupka 1 CJ NONE ❑ Roger Reese ❑ Carolyn Berrow Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Anne Jackson ❑ Glenn Thomas 0 Dale O'Reiley Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ 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. ❑ 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 ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce El James Massey, Intergovernmental Comm/TAMU Admin El Dr. Clark Ealy, Intergovernmental Comm/CSI SD ❑ 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 O Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT E l Michael Parks, Intergovernmental CommBVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff 0 Gary Teston, Intergovernmental Comm/ Easterwood Airport CC 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 Er/ NONE Brazos Valley Council of / Governments ❑ Mayor Gd' NONE B/CS Metropolitan Planning / Organization ❑ Mayor 7" NONE BVCOG TMPA Regional Park Project Advisory Board 0 Lynn Mcllhaney /NONE 0 Mayor ❑ Ron Silvia ONE ❑Aon Gay X1 NONE BVSWMA Policy Advisory Board ❑ Chris Scotti NONE ❑ Ben White ❑ Dave Ruesink ❑ Ben White 0 John Happ City Center Committee Intergovernmental Committee ❑ Dave Ruesink NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ —/ Sister Cities Association ❑ Dave Ruesink Q NONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT Q(NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford ❑ Sharon Colson ❑ Marc Chaloupka ❑ Jodi Warner Et/NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. NIP 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. 7/4e / 14t4 -NT .S Signature of person doing business with the governmental entity 447 Date Adopted 01/13/06 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. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 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. O David Gwin, Economic Dev. O David Massey, Electric ❑ Bob Cowell, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr O Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works O John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ d 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. ❑ Ben White, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council ❑ OPEN, Place 1 ❑ Lynn Mcllhaney, Place 4 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 NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ C Slocum 6/ NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ rnie Wright Di NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering ❑ Rusleen Maurice 0 Reba Ragdale ❑ Di NONE Parks and Recreation Board ❑ Jodi Warner, Chair ❑ Kathleen Ireland ❑ Joan Perry O Shawn Rhodes ❑ Jody Ford ❑ Gary Thomas 0/John Crompton 0 Harry Green 0 Gary Erwin E. NONE ❑ John Nichols, Chair O Marsha Sanford ❑ Harold Strong Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen NONE Design Review Board O Derek Dictson O Bill Davis ❑ Rick Heaney ❑ Hunter Goodwin 0 Nancy Sawtelle ❑ Alan King 0 Ward Wells 0 ohn Nichols O Susie Cox, alternate 0 Robert Rayburn, alternate NONE ❑ Jay Goss, Chair O Denise Whisenant ( NONE Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ John Richards O Thomas Mather Research Valley Partnership Board of Directors ❑ Larry Hodges Larry Mariott © ❑ Glenn Brown, City Manager NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Don Lewis 0 Charles Taylor ❑ Gregg Baird ❑/ Sheryl Welford ❑ Chad Jones ® NONE Northgate Tax Increment Finance Board O Stephen Syptak, Chair 0 David Scarmardo Tom Kirkland 0 Glenn Thomas 1311 NONE ❑ Hugh Lindsay, Area I O John Crompton, Area II ❑ Steve Arden, Area III O Hugh Stearns, Area IV O Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II D Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman ❑ arc Chaloupka NONE O Roger Reese O Carolyn Berrow ❑ Anne Jackson O Dale O'Reiley ❑ David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area II O Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident O 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 O James Massey, Intergovernmental Comm/TAMU Admin O 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 O Rodney Weis, Intergovernmental Comm/TAMU Transit ❑ Dr. Colleen Netterville, Intergovernmental Comm/BISD O Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG 0 o I 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 O Lynn Mcllhaney 0 Ben White NONE Brazos Valley Council of Governments O Mayor tZliNONE B/CS Metropolitan Planning Organization O Mayor tiNONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney NONE BVSWMA Policy Advisory Board O Mayor 0 Chris Scotti NONE ❑ Ron Silvia Id NONE O Ron Gay NONE City Center Committee 0 Ben White 0 Dave Ruesink Intergovernmental Committee 0 Ben White 0 John Happ 0/Dave Ruesink Id NONE ❑ Dave Ruesink ❑ Ron Gay ❑ Ken Fogle ❑ Michael Parker, BVCOG ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Joint City/School Intergovernmental Committee O Ben White Sister Cities Association NONE Transportation Committee O John Happ ❑ Linda LaSuit, MPO O Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee ❑ Chris Scotti O Marsha Sanford O Sharon Colson O John Happ O Lynn Mcllhaney ❑ ennis Christianson, TTI NONE ❑ Marc Chaloupka ❑Jodi Warner NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. �(P 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. ,u,11/41°tt001 Signature of person doing business w governmental entity Date Adopted 01 /1 3/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. MARK Dun c,e LI - CON,T'R(XTl ON, LTD. 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 ❑ 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 o o 0 0 o ❑/ 0' 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 ❑ LLynn Mcllhaney, Place 4 B NONE ❑ John Happ, 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 ❑ ve Parker, alternate l7' NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ Rp Slocum t7 'NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr o 9. Carroll Johnson 0' NONE ❑ Kevin Myers ❑ Joe Wallace O James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe O yrnie Wright ®'NONE Historic Preservation Committee O Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee O Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering ❑ usleen Maurice 0 Reba Ragdale 0 Kid NONE O Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton IS/NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission O John Nichols, Chair 0 Glenn Schroeder ❑ Marsha Sanford 0 nnis Christiansen ❑ Harold Strong L9' NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle O Alan King 0 Ward Wells ❑�John Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate ®'NONE ❑ Jay Goss, Chair ❑ Denise Whisenant NONE Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune O John Richards O Thomas Mather ❑ Larry Hodges O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair om Kirkland DONE O Hugh Lindsay, Area I ❑ John Crompton, Area II ❑ Steve Arden, Area III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ yarry Mariott (Q NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑"fiery' Welford Gd NONE Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman ❑ Marc Chaloupka NONE ❑ Roger Reese ❑ Carolyn Berrow O Anne Jackson O Dale O'Reiley ❑ 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 O Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate O Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce ❑ Linda LaSut, Intergovernmental Comm/MPO ❑ Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce O James Massey, Intergovernmental 0 Comm/TAMU Admin O Dr. Clark Ealy, Intergovernmental 0 Comm/CSISD ❑ Chuck Martinez, 0 Intergovernmental Comm/ Research Valley Patnership Rodney Weis, Intergovernmental Comm/TAMU Transit Dr. Colleen Netterville, Intergovernmental Comm/BISD Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT O Michael Parks, Intergovernmental CommBVCOG O Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental mm/ Easterwood Airport ZONE 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 O Lynn Mcllhaney 0 Ben White XsIONE 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 O Lynn Mcllhaney 1' NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti NONE City Center Committee ❑ iton Silvia 0 Ben White 0 Dave Ruesink d NONE Intergovernmental Committee O on Gay 0 Ben White 0 John Happ Sii NONE ❑ pave Ruesink LV/NONE ❑ Dave Ruesink Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association L9' NONE Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO 0 nnis Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT 1 NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti O Marsha Sanford ❑ Sharon Colson ❑ Marc Chaloupka O Jadi Warner Q 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. t\VA 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. '_�l� • �ie i -410 Signature of person doing business with the go ental entity June 7, 2-007 Date Adopted 01/13/06 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. FORM CIQ 1. Name of person doing business with local governmental entity. M0 k tud Ie - Presidekv+ +lie eneral 1701--kiershp 2. 00a �e C cA-1 ovn 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 ❑ 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. ❑ Olivia Burnside, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ d Spillane, Municipal Judge 13, 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 ❑ Ron Silvia, Mayor 0 Ben White, Place 1 ❑ Ron Gay, Place 3Oj.ynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 L9 NONE ❑ John Happ, 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 NONE B/CS Library Committee ❑ Katherine Edwards 0 Don Scherr ❑ Jeanne Mitchell 0 B. Carroll Johnson ❑ James Bradford E;' NONE Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Kevin Myers ❑ Joe Wallace O James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright [I/NONE Historic Preservation Committee ❑ Bill Lancaster O Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering ❑/'Rusleen Maurice 0 Reba Ragdale 0 /NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton EV/NONE Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission ❑ John Nichols, Chair 0 Glenn Schroeder ❑ Marsha Sanford 0 Dennis Christiansen ❑ Harold Strong «NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin O Derek Dictson O Bill Davis ❑ Rick Heaney 0 Hunter Goodwin 0 Nancy Sawtelle ❑ Alan King 0 Ward Wells 0 yhn Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate Ea NONE ❑ Jay Goss, Chair ❑ Denise Whisenant / �iJ NONE Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune ❑ John Richards O Thomas Mather Research Valley Partnership Board of Directors ❑ Larry Hodges 0 Larry Mariott ❑ Glenn Brown, City Manager C'NONE ❑ 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 III ❑ Hugh Stearns, Area IV ❑ Andrew Burleson, Student Resident ❑ Dorthea Robinson, Alternate, ETJ Resident ❑ Chris Scotti, Councilmember ❑ Hillary Jessup, Historic Preservation ❑ Lloyd Wasserman, County Commission Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review ❑ Charles Taylor O Sheryl Welford liNONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec O Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman ❑/Marc Chaloupka lsd'NONE ❑ Roger Reese ❑ Carolyn Berrow O Anne Jackson O Dale O'Reiley ❑ 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 O Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate O 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 Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG O 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 O Lynn Mcllhaney 0 Ben White ®' NONE Brazos Valley Council of Governments O Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor 1NONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti VNONE City Center Committee O Ron Silvia 0 Ben White 0 Dave Ruesink VNONE Intergovernmental Committee ❑ on Gay 0 Ben White 0 John Happ El NONE ❑ Dave Ruesink CIINONE O Dave Ruesink Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association INNONE Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 /Dennis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT GYNONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford O Sharon Colson ❑ Marc Chaloupka O J%di Warner D' 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 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. FORM CIQ 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. ‘4-t M0.ct.Dudk • l-resid oFtkeEiont�.al 1tittl ership Signature o person doing buss s with the governmental entity M Ay 23, 2QO-7 Date Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. MARK•bUbc.E/ - PPISIDeNT OF Mi.6ENJILA 1- FAKTNBRSHIP 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 ❑ Lance Simms, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec O Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary O Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW ❑ Kathy Merrill, Asst. City Mgr. O Olivia Burnside, Inf. Tech. O Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources O Ed Spillane, Municipal Judge Gil NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: N�R 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 ❑ Lynn Mcllhaney, Place 4 d NONE ❑ John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester O Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate Si NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox ❑ Larry D. Patton O Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson GYNONE ❑ Kevin Myers ❑ Joe Wallace O James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright d NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering ❑ Rusleen Maurice ❑ Reba Ragdale ❑ li NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes Cl John Crompton tar/NONE Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ John Nichols, Chair ❑ Glenn Schroeder ❑ Marsha Sanford 0 Dennis Christiansen ❑ Harold Strong C'NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heaney ❑ Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King ❑ Ward Wells ❑ John Nichols ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate IdNONE ❑ Jay Goss, Chair ❑ Denise Whisenant RJ NONE Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard O Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland NONE O Hugh Lindsay, Area I ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑/ Larry Mariott © NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford Ii(NONE 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 ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman ❑ Marc Chaloupka NONE ❑ Roger Reese O Carolyn Berrow O Anne Jackson O Dale O'Reiley ❑ 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 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 Comm/TxDOT ❑ Michael Parks, Intergovernmental CommBVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport d 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 O Lynn Mcllhaney 0 Ben White 13(NONE Brazos Valley Council of Governments O Ron Silvia, Mayor 1l NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor 'NONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney 'NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti 'NONE City Center Committee O Ron Silvia 0 Ben White 0 Dave Ruesink /NONE Intergovernmental Committee O Ron Gay 0 Ben White 0 John Happ NONE 1❑ Dave Ruesink NJ NONE O Dave Ruesink Joint City/School Intergovernmental Committee O Ben White 0 John Happ / Sister Cities Association ® NONE • Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford O Sharon Colson ❑ Marc Chaloupka ❑ Jodi Warner (NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. N/A 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 of person doing business with the governme MAy 1, 2007 Date Adopted 01/13/06 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. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Dl tdtP.t i Cox\st-ni cel ov `c DuLueti 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 ❑ 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. ❑ Olivia Burnside, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ Edlane, Municipal Judge Esi NONE zSifil 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 0 Ben White, Place 1 ❑ Ron Gay, Place 3 ❑ Lynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 6YNONE ❑ John Happ, 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 ❑ S ve Parker, alternate 0' NONE B/CS Library Committee ❑ Katherine Edwards ❑ Don Scherr ❑ Jeanne Mitchell 0 Barroll Johnson ❑ James Bradford -NONE Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ R5 Slocum Q' NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate O Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe O E ie Wright ONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne 0 Deborah Deitering O Rysleen Maurice ❑ Reba Ragdale ❑ 10/ONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ yin Crompton NONE ❑ John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford Cl Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ De • Christiansen NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin O Derek Dictson O Bill Davis ❑ Rick Heaney ❑ Hunter Goodwin 0 Nancy Sawtelle ❑ Alan King ❑ Ward Wells ❑ Jo Nichols ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate NONE ❑ Jay Goss, Chair 1❑ nise Whisenant NONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ y6m Kirkland glIrd NONE ❑ Hugh Lindsay, Area I ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ La'y Mariott [9'NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor O Speryl Welford NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ 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 ❑ 1,ce Chaloupka NONE ❑ Roger Reese O Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ 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 ❑ 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 CommBISD ❑ Margie Lucas, Intergovernmental Comm/ Brazos Transit District ❑ Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Cm/ Easterwood Airport D' 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 O Lynn Mcllhaney 0 Ben White Q NONE Brazos Valley Council of Governments O Ron Silvia, Mayor NONE B/CS Metropolitan Planning rganization O Ron Silvia, Mayor ❑'NONE BVCOG TMPA Regional Park Pro'�ect Advisory Board O Lynn Mcllhaney NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti ONE City Center Committee ❑ R�Silvia 0 Ben White 0 Dave Ruesink Q NONE Intergovernmental Committee ❑ Ron Gay 0 Ben White 0 John Happ 2 NONE ❑ Dye Ruesink D O E ❑ Dave Ruesink Joint City/School Intergovernmental Committee O Ben White 0 John Happ ytte"r Cities Association E Transportation Committee ❑ Ron Gay 0 John Happ 0 Lynn Mcllhaney ❑ Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI ❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT NE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti O Marsha Sanford O Sharon Colson ❑ Marc Chaloupka O Jod' arner ONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. Ni/A- 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. „ive,e 5/2/07 Signature of person doing business with the governmental ent' s Date Adopted 01/13/06 CONFLICT 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 tiled 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Mark Dudley - Dudley Construction, Ltd. 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 O Pete Caler, Landfill Mgr. ❑ David Gwin, Economic Dev. ❑ David Massey, Electric ❑ Lance Simms, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ 'ferry 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 Cl Ben White, Place 1 ❑ Lynn Mcllhaney, Place 4 KI 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 U Mary Fran Troy ❑ Jeanne Mitchell ❑ B. Carroll Johnson ❑ Jennifer Bohac ❑ James Bradford 10 NONE ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune O Dan B. Sears, Chairman O Mike Lane ❑ Steve Parker, alternate ® NONE Cemetery Committee O Virginia Reese ❑ Weldon Kruger El RC Slocum ® NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox El Larry D. Patton ❑ Glenn Thomas, alternate ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright ® NONE ❑ Rebecca Eplen ❑ Rusleen Maurice El NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes O John Crompton • NONE ❑ John Nichols, Chair ❑ Marsha Sanford O Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Denise Whisenant KJ NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells El Robert Rayburn, alternate Zoning Board of Adjustments D Joshua Benn ❑ Donald Braune ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Deborah Deitcring ❑ Peggy Samson ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Nancy Sawtelle ❑ John Nichols KI NONE ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones El Stephen Syptak, Chair ❑ Torn Kirkland X] NONE ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Marion /I NONE Wolf Pen Creek TIF Board El Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford Ill NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area ❑ Brian Bochner, Area II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn McIlhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka XI NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Riley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Arca n ❑ Tom Taylor, Alternate, Area III ❑ Adrian Williams, Alternate, Area IV ❑ Douglas Rape', ETJ Resident O Mike Guido, Alternate, Resident -At -Large Cl Bill Davis, P&Z ❑ Kathleen Ireland, Parks & Rec Alternate U 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 Comm/TxDOT El Michael Parks, Intergovernmental Comm/BVCOG Cl Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport ),I 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. ❑ Lynn McIlhaney ❑ Ron Silvia, Mayor O Ron Silvia, Mayor ❑ Lynn Mcllhaney D Ron Silvia, Mayor Brazos County Health Department O Ben White S1 NONE Brazos Valley Council of Governments XI NONE B/CS Metropolitan Planning Organization Kl NONE BVCOG TMPA Regional Park Project Advisory Board )gl NONE BVSWMA Policy Advisory Board O Chris Scotti City Center Committee ❑ Ron Silvia D Bcn White Pg NONE O Ron Gay XI NONE Intergovernmental Committee O Ben White CK NONE ❑ Dave Ruesink ❑ John Happ ❑ Dave Ruesink %1 NONE Joint City/School Intergovernmental Committee ❑ Ben White 0 John Happ Sister Cities Association O Dave Ruesink Sl NONE ❑ Ron Gay O Ken Fogle ❑ Michael Parker, BVCOG ❑ Ron Gay Transportation Committee ❑ John Happ ❑ Linda LaSuit, MPG O Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee O Chris Scotti El Lynn Mcllhaney ❑ Dennis Christianson, TTI El NONE IC1 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 or business relationship. 6. March 16, 2007 Mark Dudley - President of the General Partnership Signature of person doing business with the governmental entity Date Adopted 01/13/06 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. FORM CIQ OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 2. Mari: Dudley - T)odley rn,As+nic+f ori, Lill , 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 nbt 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 liNONE ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ Terry Childers, Deputy City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. ❑ David Massey, Electric 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 ❑ L,ynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 Q/NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Katherine Edwards ❑ Larry Ringer, Chairman ❑ Mary Fran Troy ❑ Jennifer Bohac ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑/ Steve Parker, alternate lJ NONE ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger El RC Slocum 131SNONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate ❑ Don Scherr ❑ B. Carroll Johnson "NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart ❑ Charles Thomas, alternate ❑ Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright E/NONE ❑ Rebecca Eplen ❑—/Rusleen Maurice L�' NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ JJ hn Crompton G7 NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ John Nichols, Chair ❑ Glenn Schroeder ❑ Marsha Sanford ❑ Dennis Christiansen ❑ Harold Strong i "NONE Design Review Board ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Deborah Deitering ❑ Peggy Samson ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heany ❑ Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King ❑ Ward Wells ❑ John Nichols ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate 13 NONE ❑ Jay Goss, Chair ❑ Denise Whisenant Q/NONE 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 ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland C" NONE ❑ Hugh Lindsay, Area I ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ arry Mariott VNONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ 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 ❑ Marc Chaloupka R( NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Riley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Area II ❑ Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area IV ❑ Douglas Rape', ETJ Resident O 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 ❑ 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/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport E 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 ❑ Ron Silvia, Mayor /NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor 'NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Lynn Mcllhaney /NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑ Chris Scotti 'NONE City Center Committee ❑ Ron Silvia ❑ Ben White ❑ Dave Ruesink Bi NONE Intergovernmental Committee ❑ Ron Gay ❑ Ben White ❑ John Happ ii NONE ❑ Dave Ruesink NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink D NONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Lynn Mcllhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT iNONE ❑ Ron Gay Wolf Pen Creek Oversight Committee ❑ Chris Scotti q' NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. Hreetda* at,a .nee%1 Ftirerehti Signature of person doing business with the governmental e Date Deremhe 8, 2006 Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 2. OC4iQN , L -f8. 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 El Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager El Olivia Burnside, Inf. Tech. El Pete Caler, Landfill Mgr. El Harvey Cargill, City Attorney I" NONE El Michael Clancey, Police Chief El Lance Simms, Planning & Dev El John Woody, W/WW El Terry Childers, Deputy City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer El ❑ Becky Nugent, Public Relations El Julie O'Connell, Human Resources ❑ Mark Smith, Public Works El Ed Spillane, Municipal Judge E l Cheryl Turney, Purchasing Mgr. E l David Massey, Electric Describe each affiliation or business relationship with an employee checked in Question 3 above: of a 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 ❑ Lynn Mcllhaney, Place 4 G✓NONE ❑ John Happ, Place 2 0 Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman O Mary Fran Troy O Jennifer Bohac ❑ Sarah Adams, Chair O James Batenhorst O David Chester O Donald Braune ❑ Dan B. Sears, Chairman ❑ Mike Lane O Steve Parker, alternate Ea NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger ❑ RC Slocum (NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate El Don Scherr 0 B. Carroll Johnson NONE ❑ Kevin Myers ❑ Joe Wallace ❑ James Matson ❑ David Hart O Charles Thomas, alternate Cl Quinn Williams ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑/ Ernie Wright (�J NONE ❑ Rebecca Eplen Rusleen Maurice NONE ❑ Jodi Warner, Chair Cl Shawn Rhodes ❑ John Crompton NONE ❑ John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen 1 NONE Design Review Board ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Deborah Deitering ❑ Peggy Samson ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heany ❑ Hunter Goodwin ❑ Nancy Sawtelle ❑ Alan King 0 Ward Wells �❑%John Nichols ❑ Susie Cox, alternate 0 Robert Rayburn, alternate C�7 NONE ❑ Jay Goss, Chair ❑Denise Whisenant C� NONE 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 ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair Cl/Tom Kirkland NONE ❑ Hugh Lindsay, Area I ❑ 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 ❑ Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors ❑ Larry Mariott 11/ NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford 67� NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Area II ❑ 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 CI Marc Chaloupka l3 NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Riley ❑ David Hart, Alternate, Area I ❑ Dennis Corrington, Alternate, Area H ❑ 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 ❑ 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/BVCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport I 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. ❑ Lynn McIlhaney ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Lynn McIlhaney ❑ Ron Silvia, Mayor ❑ Iton Silvia NONE ❑ on Gay NI NONE Brazos County Health Department ❑ Ben White LSI NONE Brazos Valley Council of Governments (NONE B/CS Metropolitan Planning Organization INONE BVCOG TMPA Regional Park Project Advisory Board LONE BVSWMA Policy Advisory Board ❑ Chris Scotti NONE ❑ Ben White ❑ Dave Ruesink O Ben White ❑ John Happ City Center Committee Intergovernmental Committee ❑ Dave Ruesink 1 IJ NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink d NONE Transportation Committee ❑ Ron Gay 0 John Happ ❑ Lynn Mcllhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT EiNONE ❑ Ron Gay Wolf Pen Creek Oversight Committee ❑ Chris Scotti (NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: t4/A 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. NSA 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. Dsc.,,, 64. 6, 'x006 Signature of person doing business with the vernmental entity Date Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. 2. Mai V. Dudley Dual Cetl3truchoNii 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 O Steve Beachy, Parks & Rec O Glenn Brown, City Manager O Olivia Burnside, Inf. Tech. O Pete Caler, Landfill Mgr. O Harvey Cargill, City Attorney DINONE O Michael Clancey, Police Chief O Lance Simms, Planning & Dev O John Woody, W/WW O Terry Childers, Deputy City Mgr O Connie Hooks, City Secretary O Jeff Kersten, Chief Fin.Officer O Becky Nugent, Public Relations O Julie O'Connell, Human Resources O Mark Smith, Public Works O Ed Spillane, Municipal Judge O Cheryl Turney, Purchasing Mgr. O David Massey, Electric Describe each affiliation or business relationship with an employee checked in Question 3 above: NIA 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. 0 Ron Silvia, Mayor O Ron Gay, Place 3 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council O Ben White, Place 1 O Lynn Mahaney, Place 4 NONE O John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Jennifer Bohac O Sarah Adams, Chair O James Batenhorst O David Chester O Donald Braune O Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate EiNONE B/CS Library Committee O Katherine Edwards O Jeanne Mitchell O James Bradford Cemetery Committee O Virginia Reese O Weldon Kruger O RC Slocum E/NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate O Don Scherr O B. Carroll Johnson ENONE O Kevin Myers O Joe Wallace O James Matson O David Hart O Charles Thomas, alternate O Quinn Williams O Hillary Jessup, Chairman O Haskell Monroe O Ernie Wright G1NONE 0 Rebecca Eplen O Rusleen Maurice Ed NONE 0 Jodi Warner, Chair O Shawn Rhodes El John Crompton NONE Historic Preservation Committee O Bill Lancaster O Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission O John Nichols, Chair 0 Glenn Schroeder O Marsha Sanford 0 Dennis Christiansen O Harold Strong EVNONE O Rick Heany O Alan King O Susie Cox, alternate Design Review Board O Marguerite Anthony O Meredith Waller El Colleen Risinger O Deborah Deitering O Peggy Samson O Joan Perry El Gary Thomas O Gary Erwin O Derek Dictson O Bill Davis O Hunter Goodwin 0 Nancy Sawtelle O Ward Wells 0 John Nichols O Robert Rayburn, alternate NONE Zoning Board of Adjustments O Jay Goss, Chair 0 Joshua Benn 0 John Richards o enise Whisenant 0 Donald Braune 0 Thomas Mather NONE O Larry Hodges O Glenn Brown, City Manager O Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones O Stephen Syptak, Chair O Tom Kirkland C/NONE 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 O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember O Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors O Larry Mariott ["NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review O Charles Taylor O Sheryl Welford g(NONE Northgate Tax Increment Finance Board O David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I O Brian Bochner, Area II O Laurie Corbelli, Area III O Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large O Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec O Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman Marc Chaloupka NONE O Roger Reese O Carolyn Berrow O Anne Jackson O Dale O'Riley O David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area II O Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident O Mike Guido, Alternate, Resident -At -Large O Bill Davis, P&Z O Kathleen Ireland, Parks & Rec Alternate O Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. O Tedi Ellison, Intergovernmental Comm/Chamber of Commerce O James Massey, Intergovernmental Comm/TAMU Admin ❑ Dr. Clark Ealy, Intergovernmental Comm/CSISD 0 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/BVCOG rEf Gary Arnold, Intergovernmental Comm/Brazos County Sheriff Gary Teston, Intergovernmental omm/ 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 O Lynn Mcllhaney 0 Ben White C4ONE Brazos Valley Council of Governments O Ron Silvia, Mayor Gi(NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor CXONE BVCOG TMPA Regional Park Project Advisory Board O Lynn Mcllhaney ES410NE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti NKIONE City Center Committee O Ron Silvia 0 Ben White 0 Dave Ruesink NONE Intergovernmental Committee 0 Ben White 0 John Happ 0/Ron Gay 91 NONE Opave Ruesink Di NONE Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association O Dave Ruesink DKONE Transportation Committee 0 Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT NONE O Ron Gay Wolf Pen Creek Oversight Committee 0 Chris Scotti GI/NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. J. 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. i lr6e [. 1/ Npverntx.r ►4, 21)06 i'gnaturetof -n eitt doing b Nerct Signature person doingbusiness with the g wernmental entity Date Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. marg. Did lc 1 _ ad/au cori5druc-how . Ltd 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 govern 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 [ NONE ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ Terry Childers, Deputy City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer ental ❑ Becky Nugent, Public Relations O Julie O'Connell, Human Resources ❑ Mark Smith, Public Works O Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. ❑ David Massey, Electric 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. CI Ron Silvia, Mayor O Ron Gay, Place 3 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council El Ben White, Place 1 O Lynn Mcllhaney, Place 4 EINONE El John Happ, Place 2 El Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions El Larry Ringer, Chairman O Mary Fran Troy El Jennifer Bohac O Sarah Adams, Chair O James Batenhorst El David Chester O Donald Braune 0 Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate ri NONE B/CS Library Committee O Katherine Edwards 0 Jeanne Mitchell O James Bradford Cemetery Committee O Virginia Reese 0 Weldon Kruger O RC Slocum EiNONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton El Glenn Thomas, alternate O Don Scherr O B. Carroll Johnson NONE 0 Kevin Myers 0 Joe Wallace El James Matson 0 David Hart O Charles Thomas, alternate O Quinn Williams O Hillary Jessup, Chairman O Haskell Monroe O Ernie Wright NONE O Rebecca Eplen O Rusleen Maurice EI NONE O Jodi Warner, Chair O Shawn Rhodes O John Crompton l2 NONE O John Nichols, Chair O Marsha Sanford O Harold Strong O Rick Heany O Alan King O Susie Cox, alternate O Jay Goss, Chair Denise Whisenant NONE Historic Preservation Committee O Bill Lancaster O Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission O Glenn Schroeder O Dennis Christiansen NONE Design Review Board O Marguerite Anthony O Meredith Waller O Colleen Risinger O Deborah Deitering O Peggy Samson O Joan Perry O Gary Thomas O Gary Erwin O Derek Dictson 0 Bill Davis O Hunter Goodwin 0 Nancy Sawtelle O Ward Wells 0 John Nichols O Robert Rayburn, alternate d NONE Zoning Board of Adjustments O Joshua Benn O Donald Braune O John Richards O Thomas Mather O Larry Hodges O Glenn Brown, City Manager 0 Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird El Chad Jones O Stephen Syptak, Chair El(TOm Kirkland NONE O Hugh Lindsay, Area I O John Crompton, Area II El Steve Arden, Area III O Hugh Stearns, Area IV El Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember El Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors O Larry Marion LINONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair O James Massey Outside Agency Funding Review O Charles Taylor El ySheryl Welford 'NONE Northgate Northgate Tax Increment Finance Board El David Scarmardo O Glenn Thomas Comprehensive Plan Committee O John Richards, Area I El Brian Bochner, Area II El Laurie Corbelli, Area III El Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large El Lynn Mcllhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec O Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman 0 /Marc Chaloupka reNONE O Roger Reese 0 Carolyn Berrow El Anne Jackson 0 Dale O'Riley 0 David Hart, Alternate, Area I 0 Dennis Corrington, Alternate, Area II O Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident O Mike Guido, Alternate, Resident -At -Large O Bill Davis, P&Z 0 Kathleen Ireland, Parks & Rec Alternate O Bo Miles, Building & Land Development ❑ Larry Marriott, Home Builders Assoc. O Tedi Ellison, Intergovernmental Comm/Chamber of Commerce O James Massey, Intergovernmental Comm/TAMU Admin ❑ Dr. Clark Ealy, Intergovernmental Comm/CSISD O Chuck Martinez, Intergovernmental Comm/ Research Valley Patnership ❑ Linda LaSut, Intergovernmental Comm/MPO ❑ Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce O Rodney Weis, Intergovernmental Comm/TAMU Transit ❑ Dr. Colleen Netterville, Intergovernmental Comm/BISD O Margie Lucas, Intergovernmental Comm/ Brazos Transit District O Chad Bohne, Intergovernmental Comm/TxDOT O Michael Parks, Intergovernmental Comm/B VCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff O Gary Teston, Intergovernmental Comm/ Easterwood Airport —/ C� 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 O Lynn Mcllhaney 0 Ben White ©NONE Brazos Valley Council of 1 Governments O Ron Silvia, Mayor I NONE B/CS Metropolitan Planning Organization O Ron Silvia, MayorNONE BVCOG TMPA Regional Park Project Advisory Board 0 Lynn Mcllhaney NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Chris Scotti NONE City Center Committee :Von Silvia 0 Ben White 0 Dave Ruesink 4@ NONE Intergovernmental Committee O on. Gay 0 Ben White 0 John Happ Eid NONE 01Dave Ruesink gA'NONE O Dave Ruesink Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ ister Cities Association ZONE Transportation Committee O Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 9nnis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT NONE O Ron Gay Wolf Pen Creek Oversight Committee 0 Chris Scotti ZONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. 14/A 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. e5 Signature Signature o person doing business with the go /I /3/06 entity Date Adopted 01/13/06 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. MARA( DUDLE' - DuDLEU CQNs w.c.T1ON, [-rc 2. 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. ❑ Robert Alley, Fire Chief ❑ Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney El NONE O Michael Clancey, Police Chief O Lance Simms, Planning & Dev O John Woody, W/WW O Terry Childers, Deputy City Mgr ❑ Connie Hooks, City Secretary O Jeff Kersten, Chief Fin.Officer ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. ❑ David Massey, Electric Describe each affiliation or business relationship with an employee checked in Question 3 above: NSA 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. O Ron Silvia, Mayor 0 Ron Gay, Place 3 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council O Ben White, Place 1 O Lynn McIlhaney, Place 4 E/NONE O John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Jennifer Bohac O Sarah Adams, Chair O James Batenhorst O David Chester O Donald Braune O Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate Ft NONE B/CS Library Committee Ell Katherine Edwards CI Jeanne Mitchell El James Bradford Cemetery Committee O Virginia Reese O Weldon Kruger O RC Slocum riNONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate 0 Don Scherr y. Carroll Johnson WNONE El Kevin Myers O Joe Wallace El James Matson El David Hart O Charles Thomas, alternate O Quinn Williams O Hillary Jessup, Chairman O Haskell Monre O Ernie Wright VNONE O Rebecca Eplen 0 ,R.usleen Maurice Id NONE O Jodi Warner, Chair O Shawn Rhodes O John Crompton NONE O John Nichols, Chair O Marsha Sanford O Harold Strong Historic Preservation Committee E3 Bill Lancaster O Dipankar Sen O Neal Nutall, Jr. Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission O Glenn Schroeder O Dennis Christiansen G(NONE Design Review Board O Marguerite Anthony O Thomas Taylor O Colleen Risinger O Deborah Deitering O Peggy Samson O Joan Perry O Gary Thomas 0 Gary Erwin O Derek Dictson O Bill Davis O Rick Heany 0 Hunter Goodwin 0 Nancy Sawtelle O Alan King 0 Ward Wells 0 John Nichols O Susie Cox, alternate 0 Robert Rayburn, alternate N(NONE O Jay Goss, Chair O Denise Whisenant Ft NONE Zoning Board of Adjustments 0 Joshua Benn O Donald Braune O John Richards O Thomas Mather O Larry Hodges O Glenn Brown, City Manager O Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones O Stephen Syptak, Chair 0 Jom Kirkland IilNONE O Hugh Lindsay, Area I O John Crompton, Area II O Steve Arden, Area III O Hugh Stearns, Area IV 0 Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident O Chris Scotti, Councilmember Research Valley Partnership Board of Directors O arry Mariott NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair 0 James Massey Outside Agency Funding Review 0 Charles Taylor O Sheryl Welford fil'NONE Northgate Tax Increment Finance Board 0 David Scarmardo 0 Glenn Thomas Comprehensive Plan Committee 0 John Richards, Area I O Brian Bochner, Area II 0 Laurie Corbelli, Area III O Jerry Cooper, Area IV 0 Kristina Campbell, Alternate, Student Resident O Craig Hall, Resident -At -Large 0 Lynn McIlhaney, Alternate, Councilmember 0 Chris Scotti, Councilman O Marc Chaloupka NONE O Roger Reese O Carolyn Berrow 0 Anne Jackson O Dale O'Riley O David Hart, Alternate, Area I O Dennis Corrington, Altemate, Arca II O Tom Taylor, Alternate, Area III O Adrian Williams, Alternate, Area IV O Douglas Rape', ETJ Resident O Mike Guido, Alternate, Resident -At -Large 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. O Lynn Mcilhaney O Ron Silvia, Mayor O Ron Silvia, Mayor O Lynn McIlhaney O Ron Silvia, Mayor O Ron Silvia NONE O Ron Gay NONE Brazos County Health Department O Ben White /NONE Brazos Valley Council of Governments /NONE B/CS Metropolitan Planning Organization NONE BVCOG TMPA Regional Park Project Advisory Board 'NONE BVSWMA Policy Advisory Board O Chris Scotti City Center Committee O Ben White Intergovernmental Committee O Ben White NONE 0 Dave Ruesink 0 John Happ O Dave Ruesink NONE Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association O Dave Ruesink [/ONE Transportation Committee O Ron Gay 0 John Happ 0 Lynn Mcllhaney O Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI O Michael Parker, BVCOG 0 Bryan Woods, TxDOT VNONE O Ron Gay Wolf Pen Creek Oversight Committee 0 Chris Scotti EINONE 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. of ft 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. es, - _ euwra Signature of per on doing business with the gove mental entity Date October gal, 2006 Adopted 01/13/06 Covered Material Storage Facility CERTIFICATION Bid #07-14 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity 'this questionnaire is being filed in accordance with chapter 116 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must he 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. Mark Dudley - President of the General Partnership of Dudley Construction, Ltd. 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 I76.006(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 O Steve Beachy, Parks & Rec O Glenn Brown, City Manager 0 Olivia Burnside, Inf. Tech. O Pete Caler, Landfill Mgr. 0 Harvey Cargill, City Attorney 0 David Massey, Electric O Michael Clancey, Police Chief O Lance Simms, Planning & Dev O John Woody, W/WW O Terry Childers, Asst. City Mgr O Connie Hooks, City Secretary O Jeff Kersten, Chief Fin.Officer O Charles McLemore, Public Works O Becky Nugent, Public Relations O Julie O'Connell, Human Resources O Mark Smith, Asst. City Mgr O Ed Spillane, Municipal Judge O Cheryl Turney, Purchasing Mgr. XNONE 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 I 0 John Happ, Place 2 O Ron Gay, Place 3 0 Lynn McIlhaney, Place 4 0 Chris Scotti, Place 5 0 David Ruesink, Place 6 X NONE City uf College Statism 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 XNONE Cemetery Committee O Sarah Adams, Chair 0 Virginia Reese O James Batenhorst 0 Mary Lind Bryan O David Chester XNONE 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 U Larry D. Patton U David Hart, alternate O Steve Parker, alternate 0 David Ruesink, alternate XNONE Facade Improvement Program Advisory Committee O Karen Kasper, Merchant 0 Valerian Miranda, Architect 0 Rick Lemrnons, Business Owner O Joey Dunn, Dir. Planning & Dev 0 Robert Mosley, City Engineer 0 Eric Barton, CD Coordinator XNONE ❑ I Iillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor O Colleen Risinger O Rebecca Eplen ❑ Rusleen Maurice XNONE O Kathleen Ireland O Carol Blaschke O John Crompton XNONE ❑ Scott Shafer, Chairman O Marsha Sanford O Harold Strong O Rick Heany ❑ Alan King O Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy ❑ Denise Whisenant Historic Preservation Committee ❑ Dill Lancaster ❑ David Ruesink O Ernie Wright XNONE Joint Relief Funding Review Committee O J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder O Jeannie McCandless O Harry Green Planning and Zoning Commission O John Nichols O Dennis Christiansen XNON Design Review Board ❑ Hunter Goodwin O Ward Wells O Robert Rayburn, alternate Zoning Board of Adjustments ❑ Joshua Benn O Donald Braune O Derek Dictson O Marsha Crenwelge O Dipankar Sen O Neal Nutall, Jr. O Mary Sherwood ❑ Peggy Samson O Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds O Bill Davis ❑ Nancy Sawtelle ❑ Scott Shafer XNONE O John Richards ❑ Charles Taylor X NONE Research Valley Partnership Board of Directors O David Hickson 0 Larry Marion O Glenn Brown, City Manager X NONE El Sharon Colson, Chair O Kenny Mallard Wolf Pen Creek TIF Board 0 Chris Scotti, Councilman El Marsha Sanford, Vice Chair fl Marc Chaloupka 0 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 O Susan Lancaster ❑ Nancy Berry X NONE Brazos Valley Council of Governments Board of Directors O Ron Silvia, Mayor XNONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor XNONE BVCOG TMPA Regional Park Project Advisory Board O Susan Lancaster XNONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Susan Lancaster XNONE ❑ Ron Silvia X NONE ❑ Nancy Berry XNONE ❑ Nancy Berry XNONE City Center Committee El Ben White 0 Nancy Berry Intergovernmental Committee 0 Ben White 0 John Happ Joint City/School Intergovernmental Committee ❑ Ben White 0 John Happ Sister Cities Association ❑ Ron Gay XNONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Bryan Woods, TxDOT XNONE O Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee ❑ Ron Gay ❑ Chris Scotti XNONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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, R, or C is VIS. N/A A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? n Yes I I 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? n Yes n No D. Describe each affiliation or business relationship. 6. September 7, 2006 Signature of person doing business with the govemm- . entity Date Mark Dudley - President of the General Partnership Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received I. Name of person doing business with local governmental entity. MARK DurpLEy— TJct. y CONSrRucnoNI, LTD. 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 Cl Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary El Jeff Kersten, Finance d NONE O Charles McLemore, Public Works O Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works O 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 0 Don Scherr ❑ Eric Miller 0 Jeanne Mitchell 0 /Jo Berg ❑ Lois Koontz ❑ James Bradford C�' NONE Cemetery Committee ❑ Sarah Adams, Chair ❑ Virginia Reese ❑ James Batenhorst 0 Mary Lind Bryan ❑ David Chester G' NONE 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 El Larry D. Patton ❑ David Hart, alternate ❑ Steve Parker, alternate ❑ David Ruesink, alternate NONE Facade Improvement Program Advisory Committee ❑ Karen Kasper, Merchant 0 Valerian Miranda, Architect ❑ Rick Lemmons, Business Owner ❑ / Joey Dunn, Dir. Planning & Dev 0 Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator NONE ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑/ Rusleen Maurice ® NONE ❑ Kathleen Ireland ❑ Carol Blaschke John Crompton NONE ❑ Scott Shafer, Chairman ❑ Marsha Sanford O Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy O Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster ❑ David Ruesink ❑ Ernie Wright 13/NONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless O Harry Green Planning and Zoning Commission ❑ John Nichols 0/Dennis Christiansen arc NONE Design Review Board O Hunter Goodwin ❑ Ward Wells El Robert Rayburn, alternate Zoning Board of Adjustments O Joshua Benn ❑ Donald Braune ❑ Derek Dictson ❑ Marsha Crenwelge ❑ Dipankar Sen O Neal Nutall, Jr. O Mary Sherwood O Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Nancy Sawtelle ❑ Scott Shafer 13/NONE ❑ John Richards ❑ Charles Taylor d NONE Research Valley Partnership Board of Directors ❑ David Hickson ❑/Larry Marion L1 ❑ Glenn Brown, City Manager NONE ❑ Sharon Colson, Chair O Kenny Mallard Wolf Pen Creek TIF Board 0 Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair ❑/Marc Chaloupka C� O 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 O Susan Lancaster ❑ Nancy Berry 'NONE Brazos Valley Council of Governments Board of Directors O Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization O Ron Silvia, Mayor 'NONE BVCOG TMPA Regional Park Project Advisory Board O Susan Lancaster 1:47NONE BVSWMA Policy Advisory Board O Ron Silvia, Mayor 0 Susan Lancaster 'NONE ❑ Ron Silvia NONE ❑ ancy Berry 41 ONE ❑ Nancy Berry m/ NONE ❑ Ron Gay O Ron Gay O Linda LaSuit, MPO O Bryan Woods, TxDOT 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 0 John Happ Sister Cities Association 171/ NONE Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI NONE O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay 0 Chris Scotti C3/NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: 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. K l.7 Ci/fl MARCH AA. ADO4 PRES'Ae,rr OF ME NERAL PAM R3M w Signature of person doing business wi the governmental entity Date Adopted 01/13/06 CONFLICT 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. OFFICE USE ONLY Date Received 1. Name ofperson doing business with local governmental entity. DuaLEy- DiDLFy Cowsnuicrrarr, 1.72). 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 O Olivia Burnside, Inf. Tech. O Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney O John Woody, Utilities ❑ Michael Clancey, Police Chief ❑ Joey Dunn, Planning & Dev O Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary O Jeff Kersten, Finance d NONE ❑ Charles McLemore, Public Works O Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Public Works O Ed Spillane, Municipal Judge O 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. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 0 John Happ, Place 2 ❑ Susan Lancaster, Place 4 0 Chris Scotti, Place 5 D/NONE 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 J Berg O Lois Koontz 0 James Bradford R NONE Cemetery Committee O Sarah Adams, Chair 0 Virginia Reese ❑ James Batenhorst ❑_/Mary Lind Bryan ❑ David Chester Q 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 ❑ Mike Lane 0 Larry D. Patton ❑/David Hart, alternate O Steve Parker, alternate 0 David Ruesink, alternate 1 NONE Facade Improvement Program Advisory Committee ❑ Karen Kasper, Merchant 0 Valerian Miranda, Architect 0 Rick Lemmons, Business Owner ❑ Joey Dunn, Dir. Planning & Dev 0 Robert Mosley, City Engineer 0 Eric Barton, CD Coordinator NONE ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice Er NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton IIINONE ❑ Scott Shafer, Chairman ❑ Marsha Sanford ❑ Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy ❑ Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster El David Ruesink ❑ Ernie Wright Ca' 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 Gd NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments El Joshua Benn ❑ Donald Braune ❑ Derek Dictson ❑ Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Nancy Sawtelle ❑ Scott Shafer NONE ❑ John Richards ❑ Charles Taylor Er NONE O David Hickson O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Mariott El NONE Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair ❑ Marc Chaloupka 0 James Massey 131/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 J ❑ Susan Lancaster ❑ Nancy Berry LJ NONE Brazos Valley Council of Governments Board of Directors ❑ Ron Silvia, Mayor 11 NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor i NONE BVCOG TMPA Regional Park Project Advisory Board O Susan Lancaster CEJ NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑ Susan Lancaster d NONE ❑ Ron Silvia Ei NONE ❑ Nancy Berry d NONE ❑ Nancy Berry NONE City Center Committee ❑ Ben White ❑ Nancy Berry Intergovernmental Committee O Ben White 0 John Happ Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association ❑ Ron Gay 2/NONE ❑ Ron Gay ❑ Linda LaSuit, MPO O Bryan Woods, TxDOT Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI Er NONE ❑ Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay ❑ Chris Scotti IZ NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Wog( 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. t4/A 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. Pn<s t of ' e.6e1w.l Paulnera o Signature of person doing business with the governmental e tity MAlai 21, 20040 Date Adopted 01/13/06 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. FORM CIQ OFFICE USE ONLY Date Received MAR 0 8 2006 City of College Station T." Ta.'aT' 3/106 ,r,1 1 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 O Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. O Pete Cater, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief ❑ Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance ❑ NONE ❑ 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: Nolle 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. O Ron Silvia, Mayor O Ron Gay, Place 3 O Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council O Ben White, Place 1 O Susan Lancaster, Place 4 O NONE 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 0 Lois Koontz 0 James Bradford 0 NONE O Sarah Adams, Chair O James Batenhorst 0 David Chester O Dan B. Sears, Chairman O Mike Lane 0 Steve Parker, alternate Cemetery Committee O Virginia Reese O Mary Lind Bryan O NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O George McLean, Vice Chair O Larry D. Patton O David Ruesink, alternate Facade Improvement Program Advisory Committee O Kevin Myers O Joe Wallace O Frank Cox O David Hart, alternate O NONE 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 O NONE O Hillary Jessup, Chairman O Marguerite Anthony O Thomas Taylor O Colleen Risinger O Rebecca Eplen O Rusleen Maurice O NONE O Kathleen Ireland O Carol Blaschke O John Crompton O 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 O 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 O NONE Design Review Board O Hunter Goodwin O Ward Wells O Robert Rayburn, alternate Zoning Board of Adjustments O Joshua Benn O Donald Braune O Derek Dictson 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 Nancy Sawtelle O Scott Shafer O NONE O John Richards O Charles Taylor O NONE ❑ David Hickson ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Marion ❑ NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair O James Massey ❑ Chris Scotti, Councilman ❑ Marc Chaloupka ❑ 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 ❑ Ron Silvia, Mayor Brazos County Health Department ❑ Nancy Berry ❑ NONE Brazos Valley Council of Governments Board of Directors 0 NONE B/CS Metropolitan Planning Organization ❑ NONE BVCOG TMPA Regional Park Project Advisory Board ❑ NONE BVSWMA Policy Advisory Board 0 Susan Lancaster 0 NONE O Ron Silvia O NONE O Nancy Berry O NONE O Nancy Berry O 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 0 John Happ Sister Cities Association O Ron Gay 0 NONE O Ron Gay O Linda LaSuit, MPO O Bryan Woods, TxDOT Transportation Committee O John Happ O Dennis Christianson, TTI O NONE O Ken Fogle O Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay O Chris Scotti O NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Nne, Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE 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. FORM CIQ N/A 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. President of c aaexo! %srt R Shlr Signature of person doing business with e governmental entity Date Adopted 01/13/06