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HomeMy WebLinkAboutNational Electrical Systems, Inc.CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity FORM CIQ 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. NATIONAL ELECTRICAL SYSTEMS, INC. SUITE _ �UTE1 • BOONVILLE, NY 13309 Check this box if you are filing an update to a previously filed questionnaire. 2. TERRY L GENTNER MANAGER OF (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. NdN� ❑ Glenn Brown, City Manager ❑ Robert Alley, Fire Chief ❑ Pete Caler, Landfill Mgr. ❑ David Gwin, Economic Dev. ❑ David Massey, Electric ❑ Bob Cowell, Planning & Dev ❑ Cheryl Turney, Purchasing Mgr. ❑ Terry Childers, Deputy City Mgr ❑ Steve Beachy, Parks & Rec ❑ Harvey Cargill, City Attorney ❑ Connie Hooks, City Secretary ❑ Becky Nugent, Public Relations ❑ Mark Smith, Public Works ❑ John Woody, W/WW El Kathy Merrill, Asst. City Mgr. ❑ Ben Roper, Inf. Tech. ❑ Michael Clancey, Police Chief ❑ Jeff Kersten, Chief Fin.Officer ❑ Julie O'Connell, Human Resources ❑ Ed Spillane, Municipal Judge ❑ NONE Describe each affiliation or business relationship with an employee checked in Question 3 above: l,' 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. t4 O Ben White, Mayor O Ron Gay, Place 3 O David Ruesink, Place 6 City of College Station Elected Officials College Station City Council O OPEN, Place 1 O Lynn Mcllhaney, Place 4 O NONE El James Massey, Place 2 O Chris Scotti, Place 5 City of College Station Committees, Boards, and Commissions O Larry Ringer, Chairman O Mary Fran Troy O Sonio Margarita Gangotena O Sarah Adams, Chair O James Batenhorst O David Chester GI Donald Braune O Dan B. Sears, Chairman O Mike Lane O Steve Parker, alternate O NONE B/CS Library Committee O Katherine Edwards O Jeanne Mitchell 0 James Bradford Cemetery Committee 0 Virginia Reese 0 Weldon Kruger O RC Slocum O NONE Construction Board of Adjustments and Appeals/Building & Standards Commission O Frank Cox O Larry D. Patton O Glenn Thomas, alternate O Don Scherr O B. Carroll Johnson CI NONE O Kevin Myers O Joe Wallace O James Matson O David Hart CI Charles Thomas, alternate O Quinn Williams O Hillary Jessup, Chairman O Haskell Monroe 0 Ernie Wright O NONE Historic Preservation Committee O Bill Lancaster O Jane Hughey O Neal Nutall, Jr. Joint Relief Funding Review Committee O Marguerite Anthony O Meredith Waller O Colleen Risinger O Tedi Ellison 0 J. Kevin Byrne 0 Deborah Deitering O Rusleen Maurice 0 Reba Ragdale 0 O NONE O Jodi Warner, Chair O Shawn Rhodes O John Crompton O NONE O John Nichols, Chair O Marsha Sanford O Harold Strong O Rick Heaney O Alan King O Susie Cox, alternate O Jay Goss, Chair O Denise Whisenant O NONE Parks and Recreation Board 0 Kathleen Ireland O Jody Ford O Harry Green Planning and Zoning Commission 0 Glenn Schroeder O Dennis Christiansen O NONE Design Review Board O Hunter Goodwin 0 Ward Wells O Robert Rayburn, alternate Zoning Board of Adjustments O Joshua Benn 0 Donald Braune CI Joan Perry O Gary Thomas CI Gary Erwin CI Derek Dictson O Bill Davis CI Nancy Sawtelle CI John Nichols CI NONE 0 John Richards 0 Thomas Mather O Larry Hodges O Glenn Brown, City Manager O Sharon Colson, Chair O Kenny Mallard O Don Lewis O Gregg Baird O Chad Jones 0 Stephen Syptak, Chair CI Tom Kirkland O NONE O Hugh Lindsay, Area I O John Crompton, Area II O Steve Arden, Area III O Hugh Stearns, Area IV O Andrew Burleson, Student Resident O Dorthea Robinson, Alternate, ETJ Resident 0 Chris Scotti, Councilmember O Hillary Jessup, Historic Preservation O Lloyd Wasserman, County Commission Research Valley Partnership Board of Directors O Larry Mariott O NONE Wolf Pen Creek TIF Board O Marsha Sanford, Vice Chair 0 James Massey Outside Agency Funding Review O Charles Taylor O Sheryl Welford O NONE Northgate Tax Increment Finance Board CI David Scarmardo CI Glenn Thomas Comprehensive Plan Committee O John Richards, Area I CI Brian Bochner, Area II O Laurie Corbelli, Area III O Jerry Cooper, Area IV O Kristina Campbell, Alternate, Student Resident El Craig Hall, Resident -At -Large CI Lynn McIlhaney, Alternate, Councilmember O Gary Erwin, Parks & Rec CI Larry Haskins, Northgate District Assoc. O Chris Scotti, Councilman O Marc Chaloupka O NONE O Roger Reese CI Carolyn Berrow O Anne Jackson CI Dale O'Reiley CI David Hart, Alternate, Area I O Dennis Corrington, Alternate, Area 11 o Tom Taylor, Alternate, Area III 1:1 Adrian Williams, Alternate, Area IV CI Douglas Rape', ETJ Resident CI Mike Guido, Alternate, Resident -At -Large O Bill Davis, P&Z CI Kathleen Ireland, Parks & Rec Alternate O 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 O Lindsey Guindi, Intergovernmental Comm/Chamber of Commerce ❑ Rodney Weis, Intergovernmental Comm/TAMU Transit ❑ Dr. Colleen Netterville, Intergovernmental CommBISD ❑ 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 Comm/ Easterwood Airport ❑ 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 Mcllhaney ❑ Mayor O Mayor ❑ Lynn Mcllhaney O Mayor ❑ Ron Silvia O NONE ❑ Ron Gay O NONE Brazos County Health Department O Ben White 0 NONE Brazos Valley Council of Governments O NONE B/CS Metropolitan Planning Organization O NONE BVCOG TMPA Regional Park Project Advisory Board O NONE BVSWMA Policy Advisory Board O Chris Scotti City Center Committee O Ben White Intergovernmental Committee O Ben White ❑ NONE ❑ Dave Ruesink O John Happ O Dave Ruesink O NONE Joint City/School Intergovernmental Committee O Ben White 0 John Happ Sister Cities Association O Dave Ruesink 0 NONE CI Ron Gay O Ken Fogle O Michael Parker, BVCOG O Ron Gay O John Nichols O Joan Perry Transportation Committee O John Happ O Linda LaSuit, MPO O Bryan Woods, TxDOT Wolf Pen Creek Oversight Committee CI Chris Scotti 0 Marsha Sanford O Sharon Colson O Lynn Mcllhaney 0 Dennis Christianson, TTI O NONE 0 Marc Chaloupka 0 Jodi Warner O 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. t.16 td L, 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. NATIONAL ELECTRICAL SYSTEMS, INC. SUITE A 13357 STATE ROUTE 12 BOONVILLE, NY 13309 Signature of person TERRY E�bYsinessL. EwNt ith.thitgovernmental entity RR MANAGER OFT GOVERNMENT SALES 7-2.3-©7 Date Adopted 01/13/06