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HomeMy WebLinkAboutSierra Mfg. Inc. .,. CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other pers6n doing business with local governmental entity I FORM CIQ I 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 just 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 thai require the statement to be filed. See Section 176.006, Local Government Code. A person committs an offJse if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. I l. Name of person doing business with local governmental entity. ~~\. ~ 00 ~~.~ t'vLC-~,A.:R~~JJ'9q? ,s.g", 2. I D Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you filJ an updated completed questionnaire with the appropriate filing authority not later than September I of the year for which an activity described in Section I 76.006(a). Local Government Code. is pending and not later than the 7th business 'day after the date the originally tiled questionnaire becomes incomplete or inaccurate.) 1 -- ._.~.. ._, .~^-~-_.. ,.-, i' "N'. "~'m ._..." ~_""'M' ,_." ____...'w. .....'_~...____. -~._~, .~"" .__" ___.,.._ 3. Describe each affiliation or business relationship \lith an employee or contractor of the local governmental entiiy ,vho hwkes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. I o Robert Alley, Fire Chief I o Steve Beachy, Parks & Rec o Glenn Brown, City Man~ger o Olivia Burnside, Inf. Te~h. ] o Pete Caler, Landfill Mgr. o Harvey Cargill, City Att~rney o John Woody, Utilities OFFICE USE ONLY Date Received 01-24-06P02:31 RCVD o Michael Clancey, Police Chief o Charles McLemore, Public Works o Joey Dunn, Planning & Dev o Don Fazzino, Legislative Liason o Kim Foutz, Economic Dev o Becky Nugent, Public Relations o Julie O'Connell, Human Resources o Mark Smith, Public Works o Connie Hooks, City Secretary o Ed Spillane, Municipal Judge o Cheryl Turney, Purchasing Mgr. o Jeff Kersten, Finance I\1'NONE Describe each affiliation or business relationship with an employee checked in Question 3 above; T I I , I 4. Deserihe eaeh affiliatio1n or business relationship with a person who is a local government officer and who appoints or employs ~ local government officer of the local government entity that is the subject of this questionnaire. City of College Station Elected Offieials College Station City Council o Ron Silvia, Mayor o Ron Gay, Place 3 o Nancy Berry, Place 6 o Ben White, Place I o Susan Lancaster, Place 4 o John Happ, Place 2 o Chris Scotti, Place 5 , , I Citi of College Station Committees, Boards, and Commissions I o Larry Ringer, Chairman! o Eric Miller I ~NONE B/CS Library Committee o Katherine Edwards o Don Scherr o Jeanne Mitchell o Jo Berg o Lois Koontz o James Bradford p-'NONE Cemetery Committee o Sarah Adams, Chair o James Batenhorst o David Chester o Virginia Reese 0 Kevin Myers o Mary Lind Bryan 0 Joe Wallace ~NONE I o Dan B. Sears, Chairman: o Mike Lane I o Steve Parker, altemate I Construction Board of Adjustments and AppealslBuilding & Standards Commission o George McLean, Vice Chair 0 Frank Cox o Larry D. Patton 0 David Hart, altemate o David Ruesink, alternate p--NONE F:u;ade I mprovemcnt Program Adyiso/'y Committee I o Karen Kasper, Merchant o Joey Dunn, Oir. Planningl& Oev r/ NONE o Valerian Miranda, Architect o Robert Mosley, City Engineer o Rick Lemmons, Business Owner o Eric Barton, CD Coordinator Historic Preservation Committee o Hillary Jessup, Chairmln o Marguerite Anthony o Thomas Taylor o Colleen Risinger o Bill Lancaster o David Ruesink o Ernie Wright IV!"NONE Joint Relief Funding Review Committee o Rebecca Eplen o Rusleen Maurice o J. Kevin Byrne o Charlotte Mikulee D"NONE Parks and Recreation Board o Kathleen Ireland o Carol Blaschke o Glenn Schroeder o Jeannie McCandless o John Crompton o Harry Green V3'NONE , I , o Scott Shafer, Chairman \ o Marsha Sanford o Harold Strong Planning and Zoning Commission o John Nichols o Dennis Christiansen ~NONE Design Review Board ORick Heany o Alan King o Susie Cox, alternate o Hunter Goodwin o Ward Wells o Robert Rayburn, alternate Zoning Board of Adjustments o Jay Goss, Chair o Graham Sheffy o Denise Whisenant o Joshua Benn o Donald Braune o Derek Dictson o Marsha Crenwelge o Dipankar Sen ONeal 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 pt1 NONE o John Richards o Charles Taylor i;iNONE o David Hickson o Glenn Brown, City Ma~ager o Sharon Colson, Chair o Kenny MaIlard Research Valley Partnership Board of Directors o Larry Mariott v< NONE Wolf Pen Creek TIF Board o Marsha Sanford, Vice Chair o James Massey o Chris Scotti, Councilman o Marc Chaloupka P(NONE The following individuals are appointed by the City Council to represent the City of College Station on joint committees with oth'er governmental agencies and community groups. o Susan Lancaster o Ron Silvia, Mayor o Ron Silvia, Mayor o Susan Lancaster o Ron Silvia, Mayor Brazos County Health Depllrtment o Nancy Berry Brazos Valley Council of Governments Board of Din'ctors Ii NONE B/CS Metropolitan Planning Organization v1' NONE BVCOG TMPA Regional Park Project Advisory Board rJ NONE BVSWMA Policy Ad\'isory Boanl o Susan Lancaster ~NONE ~ONE City Center Committee o Ron Silvia o Ben White o Nancy Berry ~NONE Intcrgovernmental Committee o Nancy Berry V"NONE o Ben White o John Happ Joint City/School Intergovernmental Committee o Nancy Berry ~NONE o Ben White o John Happ Sistcr Cities Association o Ron Gay plNONE Transportation Committec o Ron Gay Olinda LaSuit, MPO o Bryan Woods, TxDOT o John Ilapp o Dennis Christianson, TTI o Ken Fogle o Michael Parker, BVCOG It!'NONE Wolf Pen Creek Oversight Committee o Ron Gay o Chris Scotti ~ONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01113/06 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity I 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 C1Q 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? D Yes I D 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 n~med in this section AND the taxable income is not from the local govemmental entity? D , Yes D No C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves ds an officcr or director, or holds an ownership of 10 perccnt or more? DYes' D No I D. Describe each affiliation or business relationship. 6. L~ I Jz L/ /DIo Signature of person doing business with the governmental entity Date Adopted 01/13/06