HomeMy WebLinkAboutCentral Texas ConstructionCONFLICT 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.
Leis }cad T6 oNSdio16
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 Glenn Brown, City Manager
❑ Robert Alley, Fire Chief
❑ Pete Caler, Landfill Mgr.
❑ David Gwin, Economic Dev.
❑ David Massey, Electric
El Lance Simms, Planning & Dev
❑ Cheryl Turney, Purchasing Mgr.
❑ Terry Childers, Deputy City Mgr
❑ Steve Beachy, Parks & Rec
❑ Harvey Cargill, City Attorney
Cl Connie Hooks, City Secretary
❑ Becky Nugent, Public Relations
❑ Mark Smith, Public Works
❑ John Woody, W/WW
❑ Kathy Merrill, Asst. City Mgr.
❑ Olivia Burnside, Inf. Tech.
❑ Michael Clancey, Police Chief
❑ Jeff Kersten, Chief Fin.Officer
❑ Julie O'Connell, Human Resources
❑ Ed Spillane, Municipal Judge
944 ONE
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 ❑ Lynn Mcllhaney, Place 4
❑ David Ruesink, Place 6 NONE
City of College Station Committees, Boards, and Commissions
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
❑ Larry Ringer, Chairman
❑ Mary Fran Troy
❑ Sonio Margarita Gangotena
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
❑ Donald Braune
❑ Dan B. Sears, Chairman
❑ Mike Lane
❑ Steve Parker, alternate
1, NONE
B/CS Library Committee
❑ Katherine Edwards
❑ Jeanne Mitchell
O James Bradford
Cemetery Committee
O Virginia Reese
❑ Weldon Kruger
O RC Slocum
NONE
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
❑ Frank Cox
❑ Larry D. Patton
❑ Glenn Thomas, alternate
❑ Don Scherr
❑ B. Carroll Johnson
NONE
❑ Kevin Myers
❑ Joe Wallace
❑ James Matson
❑ David Hart
❑ Charles Thomas, alternate
❑ Quinn Williams
❑ Hillary Jessup, Chairman
❑ Haskell Monroe
❑ Ernie Wright
NONE
O Tedi Ellison
O Rusleen Maurice
9. NONE
❑ Jodi Warner, Chair
❑ Shawn Rhodes
❑ John Crompton
il\NONE
❑ John Nichols, Chair
❑ Marsha Sanford
❑ Harold Strong
❑ Rick Heaney
❑ Alan King
❑ Susie Cox, alternate
❑ Jay Goss, Chair
❑ Denise Whisenant
ONE
Historic Preservation Committee
❑ Bill Lancaster
O Jane Hughey
❑ Neal Nutall, Jr.
Joint Relief Funding Review
Committee
❑ J. Kevin Byrne
O Reba Ragdale
Parks and Recreation Board
❑ Kathleen Ireland
❑ Jody Ford
O Harry Green
Planning and Zoning
Commission
❑ Glenn Schroeder
O Dennis Christiansen
41, NONE
Design Review Board
O Hunter Goodwin
O Ward Wells
O Robert Rayburn, alternate
Zoning Board of Adjustments
❑ Joshua Benn
O Donald Braune
❑ Marguerite Anthony
O Meredith Waller
❑ Colleen Risinger
❑ Deborah Deitering
0
❑ Joan Perry
❑ Gary Thomas
❑ Gary Erwin
❑ Derek Dictson
❑ Bill Davis
❑ Nancy Sawtelle
❑ John Nichols
NONE
El John Richards
O Thomas Mather
❑ Larry Hodges
O Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
O Don Lewis
O Gregg Baird
O Chad Jones
O Stephen Syptak, Chair
O Tom Kirkland
1 NONE
O Hugh Lindsay, Area I
❑ John Crompton, Area II
❑ Steve Arden, Area III
O Hugh Stearns, Area IV
❑ Andrew Burleson, Student Resident
❑ Dorthea Robinson, Alternate,
ETJ Resident
O Chris Scotti, Councilmember
O Hillary Jessup, Historic
Preservation
O Lloyd Wasserman, County
Commission
Research Valley Partnership
Board of Directors
❑ Larry Marion
ANONE
Wolf Pen Creek TIF Board
❑ Marsha Sanford, Vice Chair
❑ James Massey
Outside Agency Funding Review
❑ Charles Taylor
Cl Sheryl Welford
NONE
Northgate Tax Increment
Finance Board
O David Scarmardo
❑ Glenn Thomas
Comprehensive Plan Committee
El 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.
❑ Chris Scotti, Councilman
❑ Marc Chaloupka
s°U NONE
❑ Roger Reese
❑ Carolyn Berrow
❑ Anne Jackson
❑ Dale O'Reiley
Cl David Hart, Alternate, Area I
❑ Dennis Corrington, Alternate, Area H
❑ Tom Taylor, Alternate, Area III
CI 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
O Dr. Clark Ealy, Intergovernmental
Comm/CSISD
❑ Chuck Martinez,
Intergovernmental Comm/
Research Valley Patnership
❑ Linda LaSut, Intergovernmental
Comm/MPO
O Lindsey Guindi, Intergovernmental
Comm/Chamber of Commerce
O Rodney Weis, Intergovernmental
Comm/TAMU Transit
❑ Dr. Colleen Netterville,
Intergovernmental Comm/BISD
O Margie Lucas,
Intergovernmental Comm/
Brazos Transit District
❑ Chad Bohne, Intergovernmental
Comm/TxDOT
O Michael Parks, Intergovernmental
Comm/BVCOG
❑ Gary Arnold, Intergovernmental
Comm/Brazos County Sheriff
O Gary Teston, Intergovernmental
Comm/ Easterwood Airport
ft 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 Lynn Mcllhaney ❑ Ben White C,NONE
Brazos Valley Council of
Governments
❑ Ron Silvia, Mayor 10 NONE
B/CS Metropolitan Planning
Organization
❑ Ron Silvia, Mayor lk, NONE
BVCOG TMPA Regional Park
Project Advisory Board
O Lynn Mcllhaney li NONE
BVSWMA Policy Advisory
Board
O Ron Silvia, Mayor El Chris Scotti .9k NONE
City Center Committee
❑ Ron Silvia 0 Ben White 0 Dave Ruesink
4 NONE
Intergovernmental Committee
❑ Ron Gay ❑ Ben White ❑ John Happ
NONE
❑ Dave Ruesink
1 1 NONE
0 Dave Ruesink
Joint City/School
Intergovernmental Committee
0 Ben White 0 John Happ
Sister Cities Association
NONE
Transportation Committee
❑ Ron Gay 0 John Happ ❑ Lynn Mcllhaney
❑ Ken Fogle 0 Linda LaSuit, MPO 0 Dennis Christianson, TTI
❑ Michael Parker, BVCOG 0 Bryan Woods, TxDOT A NONE
❑ Ron Gay
❑ John Nichols
❑ Joan Perry
Wolf Pen Creek Oversight
Committee
❑ Chris Scotti
❑ Marsha Sanford
❑ Sharon Colson
❑ Marc Chaloupka
❑ Jodi Warner
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 doing business w. h 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.
W r&/ Texas C`ot s9 rf C I r /(-)
1. Name of person doing business with local governmental entity.
FORM CIQ
OFFICE USE ONLY
Date Received
2.
RCheck 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
0
❑ 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 is the subject of
this questionnaire.
❑ Ron Silvia, Mayor
❑ Ron Gay, Place 3
❑ David Ruesink, Place 6
City of College Station Elected Officials
College Station City Council
❑ Ben White, Place 1
❑ Lynn Mcllhaney, Place 4
NONE
❑ John Happ, Place 2
❑ Chris Scotti, Place 5
City of College Station Committees, Boards, and Commissions
❑ Larry Ringer, Chairman
❑ Mary Fran Troy
❑ Jennifer Bohac
❑ Sarah Adams, Chair
❑ James Batenhorst
❑ David Chester
❑ Donald Braune
❑ Dan B. Sears, Chairman
❑ Mike Lane
❑ Steve Parker, alternate
XNONE
B/CS Library Committee
❑ Katherine Edwards
❑ Jeanne Mitchell
❑ James Bradford
Cemetery Committee
❑ Virginia Reese
❑ Weldon Kruger
❑ RC Slocum
7NONE
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
❑ Frank Cox
❑ Larry D. Patton
❑ Glenn Thomas, alternate
❑ Don Scherr
❑ B. Carroll Johnson
)9rNONE
❑ Kevin Myers
❑ Joe Wallace
O James Matson
❑ David Hart
O Charles Thomas, alternate
O Quinn Williams
❑ Hillary Jessup, Chairman
❑ Haskell Monre
❑ Ernie Wright
NONE
❑ Rebecca Eplen
❑ Rusleen Maurice
71" NONE
❑ Jodi Warner, Chair
❑ Shawn Rhodes
❑ John Crompton
7(NONE
Historic Preservation Committee
❑ Bill Lancaster
❑ Dipankar Sen
❑ Neal Nutall, Jr.
Joint Relief Funding Review
Committee
❑ J. Kevin Byrne
❑ Charlotte Mikulee
Parks and Recreation Board
❑ Kathleen Ireland
❑ Jody Ford
❑ Harry Green
Planning and Zoning
Commission
❑ John Nichols, Chair 0 Glenn Schroeder
❑ Marsha Sanford 0 Dennis Christiansen
❑ Harold Strong ,NONE
Design Review Board
❑ Marguerite Anthony
❑ Thomas Taylor
❑ Colleen Risinger
❑ Deborah Deitering
❑ Peggy Samson
❑ Joan Perry
❑ Gary Thomas
❑ Gary Erwin
O Derek Dictson
O Bill Davis
❑ Rick Heany 0 Hunter Goodwin 0 Nancy Sawtelle
❑ Alan King 0 Ward Wells 0 John Nichols
❑ Susie Cox, alternate 0 Robert Rayburn, alternate ' NONE
❑ Jay Goss, Chair
❑ Denise Whisenant
)( NONE
Zoning Board of Adjustments
❑ Joshua Benn
❑ Donald Braune
O John Richards
O Thomas Mather
❑ Larry Hodges
❑ Glenn Brown, City Manager
❑ Sharon Colson, Chair
❑ Kenny Mallard
❑ Don Lewis
❑ Gregg Baird
❑ Chad Jones
❑ Stephen Syptak, Chair
❑ Tom Kirkland
g 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
Research Valley Partnership
Board of Directors
❑ Larry Mariott
jd NONE
Wolf Pen Creek TIF Board
❑ Marsha Sanford, Vice Chair
❑ James Massey
Outside Agency Funding Review
❑ Charles Taylor
❑ Sheryl Welford
'NONE
Northgate Tax Increment
Finance Board
O David Scarmardo
O 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
O Chris Scotti, Councilman
❑ Marc Chaloupka
❑ NONE
❑ Roger Reese
❑ Carolyn Berrow
❑ Anne Jackson
❑ Dale O'Riley
❑ David Hart, Alternate, Area I
❑ Dennis Corrington, Alternate, Area n
❑ Tom Taylor, Alternate, Area III
❑ Adrian Williams, Alternate, Area IV
O Douglas Rape', ETJ Resident
❑ Mike Guido, Alternate,
Resident -At -Large
Ar 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 Lynn Mcllhaney 0 Ben White NONE
Brazos Valley Council of
Governments
O Ron Silvia, Mayor yi NONE
B/CS Metropolitan Planning
Organization
O Ron Silvia, Mayor y- NONE
BVCOG TMPA Regional Park
Project Advisory Board
O Lynn Mcllhaney ,kr NONE
BVSWMA Policy Advisory
Board
O Ron Silvia, Mayor 0 Chris Scotti 121 NONE
City Center Committee
❑ Ron Silvia 0 Ben White 0 Dave Ruesink
Ft/NONE
Intergovernmental Committee
❑ Ron Gay 0 Ben White 0 John Happ
y NONE
O Dave Ruesink
NONE
Joint City/School
Intergovernmental Committee
0 Ben White 0 John Happ
Sister Cities Association
O Dave Ruesink )(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 NONE
O Ron Gay
Wolf Pen Creek Oversight
Committee
0 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 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.
(i-.11,1 /164
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.
aitiRPL TIKRS eoserRuc7-e/til
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. 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
Charles McLemore, Public Works
•
■ Michael Clancey, Police Chief
■
Steve Beachy, Parks & Rec
Becky Nugent, Public Relations
•
■ Joey Dunn, Planning & Dev
■
Glenn Brown, City Manager
Julie O'Connell, Human Resources
•
■ Don Fazzino, Legislative Liason
■
Olivia Burnside, Inf. Tech.
Mark Smith, Public Works
■
■ Kim Foutz, Economic Dev
■
Pete Caler, Landfill Mgr.
Ed Spillane, Municipal Judge
■
■ Connie Hooks, City Secretary
■
Harvey Cargill, City Attorney
❑ Jeff Kersten, Finance
Cheryl Turney, Purchasing Mgr.
•
■
John Woody, Utilities
to NONE
■
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
B/CS Library Committee
College Station City Council
❑ Larry Ringer, Chairman
0 Katherine Edwards
0 Don Scherr
Ron Silvia, Mayor
■ George McLean, Vice Chair
■ Frank Cox
John Happ, Place 2
■
■ Ben White, Place 1
■
N NONE
Ron Gay, Place 3
■ James Bradford
■ David Chester
Chris Scotti, Place 5
•
■ Susan Lancaster, Place 4
■
Nancy Berry, Place 6
W. NONE
•
City of College Station Committees, Boards, and Commissions
B/CS Library Committee
❑ Larry Ringer, Chairman
0 Katherine Edwards
0 Don Scherr
0 Eric Miller
■ George McLean, Vice Chair
■ Frank Cox
■ Jeanne Mitchell
■ Jo Berg
■ Mary Lind Bryan
■ Joe Wallace
N NONE
■ Lois Koontz
■ James Bradford
Cemetery Committee
0 Sarah Adams, Chair
0 Virginia Reese
• Kevin Myers
■ George McLean, Vice Chair
■ Frank Cox
❑ Joey Dunn, Dir. Planning & Dev
It James Batenhorst
■ Mary Lind Bryan
■ Joe Wallace
■ Larry D. Patton
NONE
■ David Chester
Construction Board of
Adjustments and
Appeals/Building & Standards
Commission
• Dan B. Sears, Chairman
■ George McLean, Vice Chair
■ Frank Cox
❑ Joey Dunn, Dir. Planning & Dev
0 David Hart, alternate
■ Mike Lane
■ Larry D. Patton
E. NONE
Pi NONE
• Steve Parker, alternate
■ 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
E. NONE
Historic Preservation Committee
Joint Relief Funding Review
Committee
❑ Hillary Jessup, Chairman
❑ Bill Lancaster
• Marsha Crenwelge
❑ Marguerite Anthony
Mary Sherwood
• David Ruesink
■ Dipankar Sen
■
■
❑ Neal Nutall, Jr.
• Thomas Taylor
• Ernie Wright
Peggy Samson
'fl NONE
■
■ Colleen Risinger
Design Review Board
Joint Relief Funding Review
Committee
Parks and Recreation Board
❑ Hunter Goodwin
Rebecca Eplen
Kathleen Ireland
Mary Sherwood
•
• J. Kevin Byrne
■
■
Rusleen Maurice
E/ Charlotte Mikulee
Carol Blaschke
Peggy Samson
•
■
Gary Thomas
NONE
■
■
•
Design Review Board
Parks and Recreation Board
❑ Hunter Goodwin
• Rick Heany
Kathleen Ireland
Glenn Schroeder
Jodi Warner
•
■
■
Carol Blaschke
• Susie Cox, alternate
Jeannie McCandless
Gary Thomas
•
■
■
John Crompton
Harry Green
cs NONE
Gary Erwin
•
■
■
q NONE
Design Review Board
Planning and Zoning
Commission
❑ Hunter Goodwin
• Rick Heany
Scott Shafer, Chairman
John Nichols
Ken Reynolds
•
■
■
Marsha Sanford
• Susie Cox, alternate
Dennis Christiansen
Bill Davis
■
■
■
Harold Strong
NONE
cs NONE
•
■
Design Review Board
Zoning Board of Adjustments
❑ Hunter Goodwin
• Rick Heany
■ Nancy Sawtelle
Joshua Benn
■ Alan King
■ Ward Wells
■ Scott Shafer
■
1'1 NONE
• Susie Cox, alternate
■ Robert Rayburn, alternate
1
Zoning Board of Adjustments
Jay Goss, Chair
Joshua Benn
John Richards
•
■
■
Graham Sheffy
Donald Braune
Charles Taylor
•
■
■
Denise Whisenant
Derek Dictson
cs NONE
•
■
Research Valley Partnership
Board of Directors
Wolf Pen Creek TIF Board
David Hickson
Sharon Colson, Chair
Chris Scotti, Councilman
•
■ Larry Mariott
■
■
Glenn Brown, City Manager
01 NONE
Kenny Mallard
•
Wolf Pen Creek TIF Board
Sharon Colson, Chair
Marsha Sanford, Vice Chair
Marc Chaloupka
•
■
■
Kenny Mallard
James Massey
l
NONE
■
■
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?
1 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.
CLVI L) 61,,(,)) / 1;XGA s 6ter2 C T;
Signature of person doing business with the governmental entity Date
Adopted 1110212005