HomeMy WebLinkAboutMecham, D.L.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.
u,„ -L--
Check this box if you are filing an update to a previously filed questionnaire.
2.
(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. Name each employee or contractor of the local governmental entity who makes
recommendations to a local government officer of the governmental entity with respect to
expenditures of money AND describe the affiliation or business relationship.
Robert Alley, Fire Chief
Michael Clancey, Police Chief
❑ Charles McLemore, Public Works
•
•
Steve Beachy, Parks & Rec
Joey Dunn, Planning & Dev
❑ Becky Nugenl:, Public Relations
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■
Glenn Brown, City Manager
Don Faz7ino, Legislative Liason
❑ Julie O'Connell, Human Resources
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■
Olivia Burnside, Inf. Tech.
Kim Foutz, Economic Dev
❑ Mark Smith, Public Works
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•
Pete Caler, Landfill Mgr.
Connie Hooks. City Secretary
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■
■ Ed Spillane, Municipal Judge
Harvey Cargill, City Attorney
Jeff Kersten, Finance
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■ Cheryl Turney, Purchasing Mgr.
John Woody, Utilities
NONE
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■
4. Name each local government officer who appoints or employs local government officers of
the governmental entity for which this questionnaire is filed AND describe the affiliation or
business relationship.
City of College Station Elected Officials
City of College Station Committees, Boards, and Commissions
Facade Improvement Program
Advisory Committee
College Station City Council
B/CS Library Committee
Ron Silvia, Mayor
Larry Ringer, Chairman
• Rick Lemmons, Business Owner
John Happ, Place 2
•
■ Ben White, Place 1
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■
Ron Gay, Place 3
.: NONE
Eric Miller
Chris Scotti, Place 5
•
• Susan Lancaster, Place 4
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•
Nancy Berry, Place 6
g<VONE
S
•
City of College Station Committees, Boards, and Commissions
Facade Improvement Program
Advisory Committee
Cemetery Committee
B/CS Library Committee
Sarah Adams, Chair
Larry Ringer, Chairman
• Rick Lemmons, Business Owner
Katherine Edwards
•
Don Scherr
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■
■
.: NONE
Eric Miller
Joe Wallace
Jeanne Mitchell
■ Mary Lind Bryan
Joh�Berg
•
•
•
S
Lois Koontz
•
James Bradford
C�YNONE
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•
Facade Improvement Program
Advisory Committee
Cemetery Committee
Sarah Adams, Chair
■ Valerian Miranda, Architect
• Rick Lemmons, Business Owner
Kevin Myers
•
U Virginia Reese
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■ Robert Mosley, City Engineer
James Batenhorst
.: NONE
Joe Wallace
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■ Mary Lind Bryan
■
David Chester
4NONE
S
LONE
•
Facade Improvement Program
Advisory Committee
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
Dan B. Sears, Chairman
■ Valerian Miranda, Architect
• Rick Lemmons, Business Owner
Frank Cox
•
■ George McLean, Vice Chair
■
■ Robert Mosley, City Engineer
Mike Lane
.: NONE
David Hart, alternate
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• Larry D. Patton
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Steve Parket, alternate
S
LONE
•
• David Ruesink, alternate
Facade Improvement Program
Advisory Committee
■ Karen Kasper, Merchant
■ Valerian Miranda, Architect
• Rick Lemmons, Business Owner
■ Joey Dunn, Dir. Planning & Dev
■ Robert Mosley, City Engineer
■ Eric Barton, CD Coordinator
.: NONE
Historic Preservation Committee
Joint Relief Funding Review
Committee
Hillary Jessup, Chairman
Rebecca Eplen
Bill Lancaster
J. Kevin Byrne
Marsha Crenwelge
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■
Marguerite Anthony
Ru leen Maurice
David Ruesink
Charlotte Mikulee
Dipankar Seri
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Thomas Taylor
NONE
Ernie Wright
Harry Green
Neal Nutall, Jr.
•
•
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•
Colleen Risinger
6KONE
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Planning and Zoning
Commission
Joint Relief Funding Review
Committee
Scott Shafer, Chairman
Rebecca Eplen
Joshua Benn
J. Kevin Byrne
•
Mary Sherwood
■
•
■
Graham Sheffy
Ru leen Maurice
Bill Davis
Charlotte Mikulee
Christiansen
Peggy Samson
•
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■
0
NONE
•
Harry Green
ONE
Gary Erwin
Planning and Zoning
Commission
Parks and Recreation Board
Scott Shafer, Chairman
Kathleen Ireland
Joshua Benn
Glenn Schroeder
•
Jodi Warner
•
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■
Graham Sheffy
Carol Blaschke
Bill Davis
Jeannie McCandless
Christiansen
Gary Thomas
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■
•
Denise Whisenant
John Crompton
•
Harry Green
ONE
Gary Erwin
•
•
•
0
ONE
Planning and Zoning
Commission
Design Review Board
Scott Shafer, Chairman
Rick Heany
Joshua Benn
Ken Reynolds
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• John Nichols
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■
Marsha Sanford■Dennis
Graham Sheffy
Alan King
Bill Davis
•
Christiansen
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•
Harold Strong
1gr'NONE
Denise Whisenant
Susie Cox, alternate
•
Zoning Board of Adjustments
Design Review Board
Jay Goss, Chair
Rick Heany
Joshua Benn
Hunter Goodwin
John Richards
Nancy Sawtelle
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■
•
Graham Sheffy
Alan King
Donald Braune
Ward Wells
Char es Tayllor
Scott Shafer
•
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Denise Whisenant
Susie Cox, alternate
Derek Dictson
Robert Rayburn, alternate
ONE
ONE
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■
Zoning Board of Adjustments
Jay Goss, Chair
Joshua Benn
John Richards
•
•
■
Graham Sheffy
Donald Braune
Char es Tayllor
•
■
■
Denise Whisenant
Derek Dictson
ONE
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■
Research Valley Partnership
Board of Directors
Wolf Pen Creek TIF Board
Lar Mariott
• David Hickson
■ Chris Scotti, Councilman
• Glenn Brown, City Manager
_■
U 'NONE
•
Wolf Pen Creek TIF Board
Sharon Colson, Chair
Marsha Sanford, Vice Chair
•
■
■ Marc//Chaloupka
Kenny Mallard
James Massey
I140NE
IN
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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.
//.ft/ce.
Signature of person doing business with the governmental entity Date
Adopted 11/02/2005