HomeMy WebLinkAboutTruckmotiveCONFLICT 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.
e . O
2.
41-rtilait
FORM CIQ
OFFICE USE ONLY
Date Received
�eS,pe�J�o f kg -45 /iue
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
1 '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
❑ 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 its 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 0 Lynn Mcllhaney, Place 4
❑ David Ruesink, Place 6 L�NONE
City of College Station Committees, Boards, and Commissions
B/CS Library Committee
❑ Katherine Edwards 0 Don Scherr
❑ Jeanne Mitchell 0 B. Carroll Johnson
❑ James Bradford NONE
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
O Larry Ringer, Chairman
❑ Mary Fran Troy
O Jennifer Bohac
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
❑ Donald Braune
❑ Dan B. Sears, Chairman
❑ Mike Lane
❑ SS eve Parker, alternate
laff NONE
Cemetery Committee
❑ Virginia Reese
❑ Weldon Kruger
❑ RC Slocum
1 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
❑ Quinn Williams
❑ Hillary Jessup, Chairman
O Haskell Monroe
O Ernie Wright
t.i�' NONE
❑ Rebecca Eplen
❑ Rusleen Maurice
H'NONE
❑ Jodi Warner, Chair
❑ Shawn Rhodes
❑ John Crompton
[B ONE
❑ John Nichols, Chair
O Marsha Sanford
❑ Harold Strong
❑ Rick Heany
❑ Alan King
❑ Susie Cox, alternate
❑ Jay Goss, Chair
❑ DD ise Whisenant
t.3 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
O Jody Ford
O Harry Green
Planning and Zoning
Commission
❑ Glenn Schroeder
❑ Dennis Christiansen
C1NONE
Design Review Board
❑ Hunter Goodwin
❑ Ward Wells
❑ Robert Rayburn, alternate
Zoning Board of Adjustments
❑ Joshua Benn
❑ Donald Braune
❑ Marguerite Anthony
❑ Meredith Waller
❑ Colleen Risinger
❑ Deborah Deitering
❑ Peggy Samson
❑ Joan Perry
❑ Gary Thomas
❑ Gary Erwin
❑ Derek Dictson
❑ Bill Davis
❑ Nancy Sawtelle
❑_John Nichols
L°J NONE
❑ 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
"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
0 Larry Mariott
EEKVONE
Wolf Pen Creek TIF Board
O Marsha Sanford, Vice Chair
❑ James Massey
Outside Agency Funding Review
❑ Charles Taylor
❑ Sheryl Welford
El/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.
0 Chris Scotti, Councilman
❑ Marc Chaloupka
Cd 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
❑ 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
nun/ Easterwood Airport
0 NONE
❑ Dave Ruesink
E ONE
Joint City/School
Intergovernmental Committee
0 Ben White 0 John Happ
Sister Cities Association
O Dave Ruesink L`7 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 ESIONE
O Ron Gay
Wolf Pen Creek Oversight
Committee
0 Chris Scotti E 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