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HomeMy WebLinkAboutHughes Supply (2)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. 2. (5. 56ipply 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. 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 ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief ❑ Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance *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. ❑ Ron Silvia, Mayor ❑ Ron Gay, Place 3 ❑ Nancy Berry, Place 6 City of College Station Elected Officials College Station City Council ❑ Ben White, Place 1 0 Susan Lancaster, Place 4 £kNONE D 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 O Lois Koontz ❑ James Bradford NONE Cemetery Committee ❑ Sarah Adams, Chair ❑ Virginia Reese ❑ James Batenhorst 0 Mary Lind Bryan ❑ David Chester .NONE ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ George McLean, Vice Chair ❑ Larry D. Patton ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Karen Kasper, Merchant 0 Valerian Miranda, Architect ❑ Joey Dunn, Dir. Planning & Dev ❑ Robert Mosley, City Engineer 0 Eric Barton, CD Coordinator %.yONE ❑ Kevin Myers O Joe Wallace ❑ Frank Cox ❑ David Hart, alternate **NONE 0 Rick Lemmons, Business Owner ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice NONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton NONE ❑ Scott Shafer, Chairman O Marsha Sanford ❑ Harold Strong Cl Rick Heany ❑ Alan King ❑ Susie Cox, alternate ❑ Jay Goss, Chair ❑ Graham Sheffy ❑ Denise Whisenant Historic Preservation Committee ❑ Bill Lancaster ❑ David Ruesink ❑ Ernie Wright kNONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne O 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 ❑ Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson ❑ Jodi Warner ❑ Gary Thomas O Gary Erwin ❑ Ken Reynolds ❑ Bill Davis ❑ Nancy Sawtelle O Scott Shafer ONE Zoning Board of Adjustments ❑ Joshua Benn ❑ John Richards ❑ Donald Braune ❑ Charles Taylor 0 Derek Dictson NONE Research Valley Partnership Board of Directors ❑ David Hickson 0 Larry Marion ❑ Glenn Brown, City Manager X NONE ❑ Sharon Colson, Chair ❑ Kenny Mallard Wolf Pen Creek TIF Board ❑ Chris Scotti, Councilman ❑ Marsha Sanford, Vice Chair ❑ Marc Chaloupka O James Massey 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 ,�/ 0 Nancy Berry f.NONE Brazos Valley Council of Governments Board of Directors CI ONE B/CS Metropolitan Planning Organization e i1 NONE BVCOG TMPA Regional Park Project Advisory Board NONE BVSWMA Policy Advisory Board 0 Susan Lancaster NONE ❑ Ron Silvia NONE 0 Nancy Berry *ISLI\iONE ❑ Nancy Berry Nk.NONE City Center Committee 0 Ben White ❑ Nancy Berry Intergovernmental Committee 0 Ben White ❑ John Happ Joint City/School Intergovernmental Committee 0 Ben White 0 John Happ Sister Cities Association 0 Ron GayONE ❑ Ron Gay ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT Transportation Committee ❑ John Happ ❑ Dennis Christianson, TTI lik,ONE O Ken Fogle ❑ Michael Parker, BVCOG Wolf Pen Creek Oversight Committee 0 Ron Gay ❑ Chris Scotti ri_klONE 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. 62A h 5//12')( ,3) al oc ignature of person doing business with the governmental entity Date Adopted 01/13/06 JAN -31-2006 TUE 01:02 PM HUGHES SUPPLY FAX NO. 9796907821 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 bit 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, Set Section 176.006, Local Government Cod,:. A person committs an offense if the person violates Section 176.006, Local Government Code. An offense wider this section is a Class C misdemeanor. 1. Name of person doing business with local governmental entity. Akei ea. _x 2. A4O I a L:c1/t-i,. &-G P. 01 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 tm activity described in Section 176.006(a), Local Government Code, is pending and not later than the 7th business day liftcr 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 expendilare of money. ❑ Robert Alley, Fire Chief Cl Steve Beachy, Parks & Rec ❑ Glenn Brown, City Manager D Olivia Burnside, lnf. Tech. D Pete Caler, Landfill Mgr. ❑ 1-Iarvey Cargill, City Attorney ❑ John Woody, Utilities ❑ Michael Clancey, Police Chief Q Joey Dunn, Planning & Dev ❑ Don Fazzino, Legislative Liason ❑ Kim Foutz, Economic Dev ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Finance O NONE ❑ Charles McLernore, Public Works Cl Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ie Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl TurneyPurchasing Mgr. Describe each affiliation or business relationship with an employee checked in Question 3 above: _L /L n' cA.l M14 it./L J� C SC- �! e'SO[[ ��•� r cc iji . e"../V i4� . t S C7 f = /I PJ 1"�' hiss 1 1 thou / ti z K A et— , JAN -31-2006 TUE 01:02 PM HUGHES SUPPLY FAX Na 9796907821 P. 02 4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a locsd 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 ❑ Susan Lancaster, Place 4 ❑ Nancy Berry, Place 6 NONE City of College Station Committees, Boards, and Commissions B/CS Library Committee Cl John Happ, Place 2 ❑ Chris Scotli, Place 5 ❑ Larry Ringer, Chairman ❑ Eric Miller ❑ Lois Koontz ❑ Kn herine Edwards ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Sarah Adams, Chair 0 Virginia Reese O James Batenhorst 0 Mary Lind Bryan ❑ David Chester NONE Construction Board of Adjustments and Appeals/Building & Standards Commission ❑ Dan B. Sears, Chairman ❑ George McLean, Vice Chair 'Mike Lane ❑ Larry D. Patton O Steve Parker, alternate ❑ David Ruesink, alternate Facade Improvement Program Advisory Committee ❑ Don Scherr ❑ Jo Berg NONE ❑ Kevin Myers ❑ Joe Wallace ❑ Frank Cox ❑ David Hart, alternate ❑ NONE ❑ Karen Kasper, Merchant ❑ Valerian Miranda, Architect ❑ Rick Lemmons, Business Owner ❑ Joey Dunn, Dir. Planning SE I Jev ,l(Robert Mosley, City Engineer 'Eric Barton, CD Coordinator ❑ NONE )v'.b I le of t7 uv LQ -c Cl e t I CA -14 e -e -t. (.LS, Ez lc. A (LTD.- , bO c� cieieek5 rt.o m 143 . ,yyup�c. /`�� c(� ej Hsd /.ay ,4107 ren, • .P 6d 1.. ( 6,04 �� JAN -31-2006 TUE 01:02 PM HUGHES SUPPLY ❑ Hillary Jessup, Chairman ❑ Marguerite Anthony ❑ Thomas Taylor ❑ Colleen Risinger ❑ Rebecca Eplen ❑ Rusleen Maurice XNONE ❑ Kathleen Ireland ❑ Carol Blaschke ❑ John Crompton NONE ❑ Scott Shafer, Chairman O Marsha Sanford ❑ Harold Strong El Rick Heany ❑ Alan !Ging ❑ Susie Cox, alternate ❑ Jay Goss, Chair O Graham Sheffy ❑ Denise Whisonant FAX NO, 9796907821 P. 03 Historic Preservation Committee ❑ Bill Lancaster El David Ruesink O Ernie Wright NONE Joint Relief Funding Review Committee ❑ J. Kevin Byrne El Charlotte Mikulee Parks and Recreation Board Q Glenn Schroeder ❑ Jeannie McCandless El Harry Green Planning and Zoning Commission ❑ John Nichols El Dennis Christiansen X NONE Design Review Board ❑ Hunter Goodwin ❑ Ward Wells O Robert Rayburn, alternate El Marsha Crenwelge ❑ Dipankar Sen ❑ Neal Nutall, Jr. ❑ Mary Sherwood ❑ Peggy Samson El Jodi Warner O Gary Thomas O Gary Erwin O Ken Reynolds ❑ Bill Davis El Nancy Sawtelle ❑ Scott Shafer NONE Zoning Board of Adjustments Q Joshua Benn ❑ John Richards O Donald Braune ❑ Charles Taylor O Derek Dictson NONE JAN -31-2006 TUE 01:02 PM HUGHES SUPPLY ❑ David Hickson ❑ Glenn Brown, City Manager FAX NO, 9796907821 Research Valley Partnership Board of Directors Af Larry Mariott ❑ NONE ❑ Chris Scotts, Councilman P. 04 2- /t fJOc�J L 4 /L/t 1 M.a /1-ri� et( h e e a j -e L c! t Aulrcve,osc12._ bum s, S o tyke.. p/u,,,b..� r T'7n S. ,f -pc -40,14 £I j. Wolf Pen Creek TIF Board O Sharon Colson, Chair ❑ Marsha Sanford, Vice Chair 0 Marc Chaloupka ❑ Kenny Mallard ❑ James Massey 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 O Susan Lancaster El Nancy Berry IANONE Brazos Valley Council of Governments Board of Directors El Ron Silvia, Mayor NONE B/CS Metropolitan Planning Organization El Ron Silvia, Mayor XNONE BVCOC TMPA Regional Park Project Advisory Board O Susan Lancaster NONE BVSWMA Policy Advisory Board ❑ Ron Silvia, Mayor ❑Susan Lancaster 9(„ONE JAN -31-2006 TUE 01:02 PM HUGHES SUPPLY ❑ Ron Silvia NONE ❑ Nancy Berry ANONE ❑ Nancy Berry NONE FAX Na 9796907821 P. 05 City Center Committee O Ben White 0 Nancy Berry Intergovernmental Committee O Ben White ❑ John Happ Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association ❑ Ron Gay XNONE Transportation Committee ❑ Ron Gay 0 John Happ Cl Linda LaSuit, MPO 0 Dennis Christianson, TT1 ❑ Bryan Woods, TxDOT NONE ❑ Ron Gay Wolf Pen Creek Oversight Committee 0 Chris Scotti O Ken Fogle ❑ Michael Parker, BVCOG Describe each affiliation or busyness relationship with an employee checked in Question 4 above: 6' e,C1C0014- . LE -17 ir. e. p )W rr, x;-,44 i 170.mf tA. S . /la ice - Adopted 01/13/06 JAN -31-2006 TUE 01:03 PM HUGHES SUPPLY FAX NO, 9796907821 P, 06 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity FORM CIQ This section, item 5 including sr bparts 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. S. Name of local government iufficer with whom filer has affiliation or business relationship. (Complete this Section only if the answer to A, B, or C is YES. /jy� �/ fLa, _CC_ azo' A. Is the local government officipr named in this section receiving or likely to receive taxable income from the filer of the questionnaire? Yes B. Is the filer of the questionnait e 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. ?I-0 Signature of person doing busk, ess with the governmental entity Date Adopted 01/13/06