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HomeMy WebLinkAboutKingsley ContractorsCONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ 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. OFFICE USE ONLY Date Received 1. Name of person doing business with local governmental entity. gvact C . g;(15s ., — 2. k: 3s tC l J L 4 raC t0C"S � 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. ❑ Glenn Brown, City Manager ❑ Terry Childers, Deputy City Mgr 0 Kathy Merrill, Asst. City Mgr. ❑ Robert Alley, Fire Chief ❑ Steve Beachy, Parks & Rec ❑ Ben Roper, Inf. Tech. El Pete Caler, Landfill Mgr. 0 Harvey Cargill, City Attorney 0 Michael Clancey, Police Chief El David Gwin, Economic Dev. 0 Connie Hooks, City Secretary ❑ Jeff Kasten, Chief Fin.Officer ❑ David Massey, Electric ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources ❑ Bob Cowell, Planning & Dcv ❑ Mark Smith, Public Works ❑ Ed Spillane, Municipal Judge ❑ Cheryl Turney, Purchasing Mgr. ❑ Dave Coleman, W/WW O'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. ❑ Ben White, Mayor ❑ Ron Gay, Place 3 ❑ David Ruesink, Place 6 City of College Station Elected Officials College Station City Council El John Compton, Place 1 ❑ Lynn Mcllhaney, Place 4 Ca'NONE O James Massey, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions B/CS Library Committee ❑ Katherine Edwards O Larry Ringer, Chairman O Mary Fran Troy ❑ Sonio Margarita Gangotena ❑ Sarah Adams, Chair El James Batenhorst El David Chester ❑ Donald Braunc ❑ Dan B. Sears, Chairman ❑ Mike Lane ❑ Steve Parker, alternate IX'NONE ❑ Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese ❑ Weldon Kruger El RC Slocum 2 -NONE Construction Board of Adjustments and Appeals/Building & Standards Commission El Frank Cox ❑ Larry D. Patton ❑ Glenn Thomas, alternate El Don Scherr ❑ B. Carroll Johnson IONONE ❑ Kevin Myers ❑ Joe Wallace O James Matson ❑ David Bart ❑ Charles Thomas, alternate Cl Quinn Williams 1 r r r r ■ w w ■ ❑ Hillary Jessup, Chairman ❑ Haskell Monroe ❑ Ernie Wright l2 -NONE Historic Preservation Committee ❑ Bill Lancaster ❑ Jane Hughey ❑ Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ Marguerite Anthony ❑ Meredith Waller ❑ Colleen Risinger ❑ Tedi Ellison ❑ J. Kevin Byrne ❑ Deborah Deitering ❑ Rusleen Maurice ❑ Reba Ragdale ❑ I2' NONE ❑ Jodi Warner, Chair ❑ Shawn Rhodes ❑ John Crompton GI -NONE ❑ John Nichols, Chair ❑ Marsha Sanford ❑ Harold Strong Parks and Recreation Board ❑ Kathleen Ireland ❑ Jody Ford ❑ Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen I;4 -NONE Design Review Board ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin ❑ Derek Dictson ❑ Bill Davis ❑ Rick Heaney ❑ Hunter Goodwin ❑ Nancy Sawtclle ❑ Alan King ❑ Ward Wells ❑ John Nichols ❑ Susie Cox, alternate ❑ Robert Rayburn, alternate IONONE I ■ ■ ❑ Jay Goss, Chair ❑ Denise Whisenant 2'NON E Zoning Board of Adjustments ❑ Joshua Benn ❑ Donald Braune ❑ John Richards ❑ Thomas Mather ❑ Larry Hodges O Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones ❑ Stephen Syptak, Chair ❑ Tom Kirkland la -NONE D Hugh Lindsay, Area I ❑ John Crompton, Area Il ❑ Steve Arden, Area III ❑ Hugh Stearns, Area [V 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 ❑ Larry Mariott la" NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford 2 --NONE Northgate Tax Increment Finance Board ❑ David Scarmardo ❑ Glenn Thomas Comprehensive Plan Committee ❑ John Richards, Area I ❑ Brian Bochner, Arca II ❑ Laurie Corbelli, Area III ❑ Jerry Cooper, Area IV ❑ Kristina Campbell, Alternate, Student Resident ❑ Craig Hall, Resident -At -Large ❑ Lynn Mellhaney, Alternate, Councilmember ❑ Gary Erwin, Parks & Rec ❑ Larry Haskins, Northgate District Assoc. ❑ Chris Scotti, Councilman ❑ Marc Chaloupka GA -NONE ❑ Roger Reese ❑ Carolyn Berrow ❑ Anne Jackson ❑ Dale O'Reiley ❑ 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 w w M i i ❑ Larry Marriott, Home Builders Assoc. ❑ Tedi Ellison, Intergovernmental Comm/Chamber of Commerce O 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 El Chad Bohne, Intergovernmental Comm/TxDOT ❑ Michael Parks, Intergovernmental Comm/B VCOG ❑ Gary Arnold, Intergovernmental Comm/Brazos County Sheriff ❑ Gary Teston, Intergovernmental Comm/ Easterwood Airport E 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. ❑ Lynn McIlhaney Brazos County Health Department ❑ Ben White 0 -NONE Brazos Valley Council of Governments - ❑ Mayor 12r NONE B/CS Metropolitan Planning Organization O Mayor l NONE ❑ Lynn McIlhaney ❑ Mayor ❑ Ron Silvia 12" NONE ❑ Ron Gay 12. -NONE BVCOG TMPA Regional Park Project Advisory Board ET NONE BVSWMA Policy Advisory Board El Chris Scotti City Center Committee O Ben White Intergovernmental Committee O Ben White 8" NONE ❑ Dave Ruesink El John Happ i i e ■ ■ ✓ r r r ■ r ❑ Dave Ruesink R1" NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association 0 Dave Ruesink 12'NONE Transportation Committee ❑ Ron Gay ❑ John Happ ❑ Lynn Mcllhaney ❑ Ken Fogle ❑ Linda LaSuit, MPO ❑ Dennis Christianson, TTI ❑ Michael Parker, BVCOG ❑ Bryan Woods, TxDOT la NONE ❑ Ron Gay ❑ John Nichols ❑ Joan Perry Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Marsha Sanford ❑ Sharon Colson ❑ Marc Chaloupka ❑ Jodi Warner 2—NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Adopted 01/13/06 ■ ■ r r M ■ 1 i 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. 001e - 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