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HomeMy WebLinkAboutElert & AssociatesCity of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System M. Form CIQ — Conflict of Interest Questionnaire 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. FORM CIQ 1. Name of person doing business with local governmental entity. Elert & Associates 2. 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 f 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 ❑ David Massey, Electric ❑ Michael Clancey, Police Chief ❑ Lance Simms, Planning & Dev ❑ John Woody, W/WW ❑ Terry Childers, Asst. City Mgr ❑ Connie Hooks, City Secretary ❑ Jeff Kersten, Chief Fin.Officer ❑ Charles McLemore, Public Works ❑ Becky Nugent, Public Relations ❑ Julie O'Connell, Human Resources Cl Mark Smith, Asst. City Mgr ❑ Ed Spillane, Municipal Judge El Cheryl Turney, Purchasing Mgr. Ei NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: Not Applicable Elert & Associates Page 11 ..1 l City of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System 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 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council O Ben White, Place 1 O Lynn Mcllhaney, Place 4 O NONE O John Happ, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Jennifer Bohac O Sarah Adams, Chair ❑ James Batenhorst O David Chester ❑ Donald Braune ❑ Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate B/CS Library Committee ❑ Katherine Edwards O Jeanne Mitchell ❑ James Bradford Cemetery Committee ❑ Virginia Reese O Weldon Kruger ❑ RC Slocum O NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O George McLean, Vice Chair ❑ Larry D. Patton O David Ruesink, alternate O Don Scherr O B. Carroll Johnson ❑✓ NONE O Kevin Myers O Joe Wallace O James Matson O Frank Cox O David Hart, alternate 0✓ NONE Elert & Associates Page 12 E City of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System ❑ Hillary Jessup, Chairman O Haskell Monre ❑ Ernie Wright Cl NONE O Rebecca Eplen O Rusleen Maurice O NONE ❑ Jodi Warner, Chair O Shawn Rhodes O John Crompton O NONE ❑ John Nichols, Chair ❑ Marsha Sanford O Harold Strong O Rick Heany O Alan King O Susie Cox, alternate ❑ Jay Goss, Chair O Denise Whisenant ID NONE Historic Preservation Committee O Bill Lancaster ❑ Dipankar Sen O Neal Nutall, Jr. Joint Relief Funding Review Committee ❑ J. Kevin Byrne O Charlotte Mikulee Parks and Recreation Board O Kathleen Ireland ❑ Jody Ford O Harry Green Planning and Zoning Commission ❑ Glenn Schroeder ❑ Dennis Christiansen O NONE Design Review Board ❑ Hunter Goodwin O Ward Wells O Robert Rayburn, alternate Zoning Board of Adjustments ❑ Joshua Berm O Donald Braune ❑ Marguerite Anthony O Thomas Taylor O Colleen Risinger O Deborah Deitering O Peggy Samson ❑ Joan Perry ❑ Gary Thomas ❑ Gary Erwin O Derek Dictson ❑ Bill Davis ❑ Nancy Sawtelle ❑ John Nichols 0 NONE ❑ John Richards ❑ Thomas Mather Esq Elert & Associates Page 13 City of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System ❑ Larry Hodges ❑ Glenn Brown, City Manager ❑ Sharon Colson, Chair ❑ Kenny Mallard ❑ Don Lewis ❑ Gregg Baird ❑ Chad Jones Research Valley Partnership Board of Directors ❑ Larry Marion 0 NONE Wolf Pen Creek TIF Board ❑ Marsha Sanford, Vice Chair ❑ James Massey Outside Agency Funding Review ❑ Charles Taylor ❑ Sheryl Welford O NONE ❑ Chris Scotti, Councilman ❑ Marc Chaloupka O NONE ❑ Roger Reese ❑ Carolyn Berrow gill Elert & Associates Page 14 City of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System ❑ Dave Ruesink D NONE Joint City/School Intergovernmental Committee ❑ Ben White ❑ John Happ Sister Cities Association ❑ Dave Ruesink O NONE ❑ Ron Gay ❑ Ken Fogle ❑ Michael Parker, BVCOG ❑ Ron Gay Transportation Committee ❑ John Happ ❑ Linda LaSuit, MPO ❑ Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee ❑ Chris Scotti ❑ Lynn Mcllhaney ❑ Dennis Christianson, TTI ✓❑ NONE ▪ NONE Describe each affiliation or business relationship with an employee checked in Question 4 above: Not Applicable Adopted 01/13/06 Elert & Associates Page 15 City of College Station Proposal for Engineering & Design of Replacement 800 MHz Radio System 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 he 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. Not Applicable Signature of person doing business with the governmental entity le / -716, Date Adopted 01/13/06 MSiert & Associates Page 16