Loading...
HomeMy WebLinkAboutBrookway Horticultural ServicesCONFLICT 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. L..o1'KDr*t =�Qc�k 2. FORM CIQ OFFICE USE ONLY Date Received XAVIA.-VUsral nc„ 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. El Robert Alley, Fire Chief ❑ Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ David Massey, Electric ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ Charles Wood, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance ❑ Charles McLemore, Public Works El Charles McLemore, Public Works El Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Mark Smith, Special Projects ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. X 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 ❑ Ben White, Place I ❑ Ron Gay, Place 3 ❑ Lynn Mcllhaney, Place 4 ❑ David Ruesink, Place 6 tg NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Eric Miller ❑ Lois Koontz B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Sarah Adams, Chair ❑ Virginia Reese ❑ James Batenhorst ❑ Mary Lind Bryan ❑ David Chester Pt NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Don Scherr ❑ Jo Berg NONE ❑ Kevin Myers ❑ Joe Wallace ❑ Dan B. Sears, Chairman 0 George McLean, Vice Chair ❑ Frank Cox ❑ Mike Lane ❑ 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 ❑ Robert Mosley, City Engineer ❑ Eric Barton, CD Coordinator NONE Historic Preservation Committee ❑ Hillary Jessup, Chairman ❑ Bill Lancaster ❑ Marguerite Anthony ❑ David Ruesink ❑ Thomas Taylor ❑ Ernie Wright ❑ Colleen Risinger NONE ❑ Rebecca Eplen ❑ Rusleen Maurice NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton 9( 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 ❑ Scott Shafer, Chairman ❑ John Nichols ❑ Marsha Sanford ❑ Dennis Christiansen ❑ Harold Strong NONE ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy ❑ Denise Whisenant Design Review Board ❑ Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments ❑ 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 NONE Research Valley Partnership Board of Directors ❑ David Hickson ❑ Larry Mariott ❑ Glenn Brown, City Manager X NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ 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. Brazos County Health Department ❑ Susan Lancaster ❑ Nancy Berry NONE Brazos Valley Council of Governments Board of Directors ❑ Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor xtNONE BVCOG TMPA Regional Park Project Advisory Board ❑ Susan Lancaster NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑ Susan Lancaster ,NONE ❑ Ron Silvia 1 NONE ❑ Nancy Berry NONE ❑ Nancy Berry X NONE ❑ Ron Gay ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT City Center Committee ❑ Ben White Intergovernmental Committee ❑ Ben White Joint City/School Intergovernmental Committee ❑ Ben White Sister Cities Association NONE Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI NONE ❑ Nancy Berry ❑ John Happ ❑ John Happ ❑ Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee ❑ Ron Gay ❑ Chris Scotti J:( 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 l'his 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 with the governmental entity �1 I Q 5 \Glp 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. . o MICK \14 t - B ookw ay HeO1.v ltv c 1, -1e.v lc.e , \ nc . . 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 ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief ❑ Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev O Connie Hooks, City Secretary O Jeff Kersten, Finance T, NONE O 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: 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 O Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 ❑ Susan Lancaster, Place 4 . NONE ❑ John Happ, Place 2 ❑ Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Eric Miller ❑ Lois Koontz B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Sarah Adams, Chair ❑ Virginia Reese O James Batenhorst ❑ Mary Lind Bryan ❑ David Chester . NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Don Scherr ❑ Jo Berg Vi NONE ❑ Kevin Myers ❑ Joe Wallace ❑ Dan B. Sears, Chairman 0 George McLean, Vice Chair ❑ Frank Cox ❑ Mike Lane ❑ Larry D. Patton 0 David Hart, alternate ❑ Steve Parker, alternate 0 David Ruesink, alternate pgi, 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 ❑ Harold Strong ❑ Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy El Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster ❑ David Ruesink ❑ Ernie Wright NONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne ❑ Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless El Harry Green Planning and Zoning Commission ❑ John Nichols ❑ Dennis Christiansen *, NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments ❑ 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 NONE Research Valley Partnership Board of Directors ❑ David Hickson ❑ Larry Mariott ❑ Glenn Brown, City Manager 71, NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ 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. Brazos County Health Department ❑ Susan Lancaster ❑ Nancy Berry t, NONE Brazos Valley Council of Governments Board of Directors ❑ Ron Silvia, Mayor -, NONE B/CS Metropolitan Planning Organization ❑ Ron Silvia, Mayor ,NONE BVCOG TMPA Regional Park Project Advisory Board ❑ Susan Lancaster 3A,NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑ Susan Lancaster 74. NONE ❑ Ron Silvia NONE ❑ Nancy Berry ), NONE ❑ Nancy Berry It. NONE City Center Committee ❑ Ben White ❑ Nancy Berry Intergovernmental Committee ❑ Ben White ❑ John Happ Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Ron Gay Yl. NONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Linda LaSuit, MPO ❑ Dermis Christianson, TTI ❑ Bryan Woods, TxDOT ty,NONE ❑ Ken Fogle 0 Michael Parker, BVCOG Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 Wolf Pen Creek Oversight Committee Ron Gay Chris Scotti Al 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. 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. 1. Name of person doing business with local governmental entity. L-oRndw \\-- 2. FORM CIQ OFFICE USE ONLY Date Received MAR 2 0 2006 City of C:ofteye Station any Hot2t\(..v1tvok1 SeKv►ces, Inc,_ 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 O Steve Beachy, Parks & Rec O Glenn Brown, City Manager ❑ Olivia Burnside, Inf. Tech. ❑ Pete Caler, Landfill Mgr. ❑ Harvey Cargill, City Attorney ❑ John Woody, Utilities O Michael Clancey, Police Chief O Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary O Jeff Kersten, Finance igt 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: 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 El Susan Lancaster, Place 4 ❑ Nancy Berry, Place 6 I, 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 ❑ Eric Miller ❑ Jeanne Mitchell 0 Jo Berg ❑ Lois Koontz 0 James Bradford ,J NONE ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester Cemetery Committee ❑ Virginia Reese ❑ Mary Lind Bryan xi NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Kevin Myers ❑ Joe Wallace ❑ Dan B. Sears, Chairman ❑ George McLean, Vice Chair 0 Frank Cox ❑ Mike Lane ❑ Larry D. Patton ❑ David Hart, alternate ❑ Steve Parker, alternate ❑ David Ruesink, alternate 1NI NONE 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 IA NONE ❑ Hillary Jessup, Chairman O Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice jos NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton IS NONE ❑ 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 ❑ David Ruesink ❑ Ernie Wright 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 NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells ❑ Robert Rayburn, alternate Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ Derek Dictson El Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson ❑ Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds O Bill Davis O Nancy Sawtelle ❑ Scott Shafer pit NONE ❑ John Richards ❑ Charles Taylor Ig NONE El David Hickson 0 Glenn Brown, City Manager El Sharon Colson, Chair ❑ Kenny Mallard Research Valley Partnership Board of Directors ❑ Larry Mariott 161 NONE Wolf Pen Creek TIF Board El Marsha Sanford, Vice Chair ❑ James Massey ❑ Chris Scotti, Councilman ❑ Marc Chaloupka g 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 El Nancy Berry 141 NONE Brazos Valley Council of Governments Board of Directors Ji4 NONE B/CS Metropolitan Planning Organization Al NONE BVCOG TMPA Regional Park Project Advisory Board IS NONE BVSWMA Policy Advisory Board El Susan Lancaster Ikr NONE Cl Ron Silvia Jig NONE ❑ Nancy Berry Pel NONE ❑ Nancy Berry 14 NONE City Center Committee ❑ Ben White ❑ Nancy Berry Intergovernmental Committee ❑ Ben White ❑ John Happ Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association O Ron Gay JA NONE ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI 1g NONE ❑ Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee O Ron Gay ❑ Chris Scotti f 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 with the governmental entity Date Adopted 01/13/06