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HomeMy WebLinkAboutElliott ElectricCONFLICT OF INTEI For vendor or other person This questionnaire is being fi. Government Code by a perso By law this questionnaire mu local government not later th becomes aware of facts that r 176.006, Local Government EST QUESTIONNAIRE doing business with local governmental entity ed in accordance with chapter 176 of the Local i doing business with the governmental entity. t be filed with the records administrator of the n the 7th business day after the date the person quire the statement to be filed. See Section ode. A person committs an offens if the person violates Section 176.006, Local Government Code. An offens under this section is a Class C misdemeanor. 1. Name of person doing bt siness with local governmental entity. :... :.>C.: v.v..............:.:.::..:....... 2. FORM CIQ OFFICE USE ONLY Date Received Check this bo if you are filing an update to a previously filed questionnaire. (The law requires that you file September 1 of the year for whi not later than the 7th business updated completed questionnaire with the appropriate filing authority not later than h an activity described in Section 176.006(a), Local Government Code, is pending and after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3. Describe each affiliation r 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. O Pete Caler, Landfill Mgr. O Harvey Cargill, City Attorney ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief O Joey Dunn, Planning & Dev O Don Fazzino, Legislative Liason O Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance NONE ❑ Charles McLemore, Public Works O Becky Nugent, Public Relations O Julie O'Connell, Human Resources O 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 ocal 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 O Susan Lancaster, Place 4 41 NONE ❑ John Happ, Place 2 O Chris Scotti, Place 5 City o College Station Committees, Boards, and Commissions ❑ Larry Ringer, Chairman ❑ Eric Miller O Lois Koontz ❑ Sarah Adams, Chair ❑ James Batenhorst ❑ David Chester ❑ Dan B. Sears, Chairman ❑ Mike Lane O Steve Parker, alternate ❑ Karen Kasper, Merchant ❑ Joey Dunn, Dir. Planning & iSi NONE B/CS Library Committee ❑ Katherine Edwards ❑ Jeanne Mitchell O James Bradford Cemetery Committee ❑ Virginia Reese O Mary Lind Biyan ,Hi NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair ❑ Larry D. Patton ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Valerian Miranda, Architect ev ❑ Robert Mosley, City Engineer ❑ Don Scherr ❑ Jo Berg .12i NONE ❑ Kevin Myers O Joe Wallace O Frank Cox ❑ David Hart, alternate A NONE ❑ Rick Lemmons, Business Owner ❑ Eric Barton, CD Coordinator ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony El Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice NONE ❑ Kathleen Ireland O Carol Blaschke ❑ John Crompton ra,. NONE ❑ Scott Shafer, Chairman O Marsha Sanford O 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 AlNONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne El Charlotte Mikulee Parks and Recreation Board ❑ Glenn Schroeder ❑ Jeannie McCandless ❑ Harry Green Planning and Zoning Commission ❑ John Nichols ❑ Dennis Christiansen NONE Design Review Board ❑ Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. El Mary Sherwood ❑ Peggy Samson El Jodi Warner ❑ Gary Thomas ❑ Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Hunter Goodwin ❑ Nancy Sawtelle ❑ Ward Wells El Scott Shafer ❑ Robert Rayburn, alternate XNONE Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ Derek Dictson ❑ John Richards El Charles Taylor 34 NONE Research Valley Partnership Board of Directors ❑ David Hickson ❑ Larry Mariott O Glenn Brown, City Mana : er iir NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair 0 Marc Chaloupka O James Massey j* NONE The following individuals a e appointed by the City Council to represent the City of College Station on joint committees with other governmental agencies and community groups. 0 Susan Lancaster ❑ Ron Silvia, Mayor ❑ Ron Silvia, Mayor ❑ Susan Lancaster ❑ Ron Silvia, Mayor Brazos County Health Department 0 Nancy Berry 0 NONE Brazos Valley Council of Governments Board of Directors Of NONE B/CS Metropolitan Planning Organization 91 NONE BVCOG TMPA Regional Park Project Advisory Board NONE BVSWMA Policy Advisory Board 0 Susan Lancaster %NONE ❑ Ron Silvia A NONE ❑ Nancy Berry 1 NONE ❑ Nancy Berry [' NONE ❑ Ron Gay ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT City Center Committee ❑ Ben White 0 Nancy Berry Intergovernmental Committee ❑ Ben White 0 John Happ Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association [NONE Transportation Committee ❑ John Happ 0 Dennis Christianson, TTI ,Lii' NONE ❑ Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee ❑ Ron Gay ❑ Chris Scotti ,'NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity 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. Signature of person • oing business with the governmental entity Date Adopted 01/13/06