Conflict of Interest Questionnaire. Chapter 176 of the Texas Local Government Code requires contractors contracting or seeking to contract with H-GAC to file a conflict of interest questionnaire (CIQ) if they have an employment or other business relationship with an H-GAC officer or an officer’s close family member. The required questionnaire and instructions are located on the H-GAC website or at the Texas Ethics Commission website xxxxx://xxx.xxxxxx.xxxxx.xx.xx/forms/CIQ.pdf. H-GAC officers include its Board of Directors and Executive Director, who are listed on this website. Respondent must complete and file a CIQ with the Texas Ethics Commission if an employment or business relationship with H-GAC office or an officer’s close family member as defined in the law exists.
Conflict of Interest Questionnaire. If you have a conflict of interest as described in this form No FORM CIQ or the Local Government Code Chapter 176, cited therein- you are required to complete and file with TIPS, Xxxxxxx Xxxxxx, 0000 XX Xxxxxxx 000 Xxxxx, Xxxxxxxxx, Xxxxx 00000 You may find the Blank CIQ form on our website at: Copy and Paste the following link into a new browser or tab: xxxxx://xxx.xxxx-xxx.xxx/assets/documents/docs/CIQ.pdf Do you have any conflicts under this statutory requirement? 50 Filing of Form CIQ If yes (above), have you filed a form CIQ as directed here? 51 Regulatory Standing I certify to TIPS for the proposal attached that my Yes company is in good standing with all governmental agencies Federal or state that regulate any part of our business operations. If not, please explain in the next attribute question. 52 Regulatory Standing Regulatory Standing explanation of no answer. 53 Antitrust Certification Statements (Tex. By submission of this bid or proposal, the Bidder certifies (No Response Required) Government Code § 2155.005) that: I affirm under penalty of perjury of the laws of the State of Texas that:
Conflict of Interest Questionnaire. For vendor doing business with local governmental entity FORM CIQ This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. OFFICE USE ONLY Date Received 1 Name of vendor who has a business relationship with local governmental entity. 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 the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information in this section is being disclosed. Name of Officer This section (item 3 including subparts A, B, C, & D) must be completed for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.
Conflict of Interest Questionnaire. If required by Chapter 176, Texas Local Government Code, the Consultant shall complete and file the Conflict of Interest Questionnaire with the County Clerk, Elections Division, 0000 Xxxxxxx Xxxx., Xxxxxx, Xxxxx 00000. If any statement on a submitted Questionnaire becomes incomplete or inaccurate, the Consultant shall submit an updated Questionnaire not later than the seventh (7th) working day after the date of the event that caused the statement to become incomplete or inaccurate. The Consultant should note that the law requires the County to provide access to a filed Questionnaire on the official Travis County Internet website. As a duly authorized representative of Consultant, I acknowledge by my signature below that I have read and understand the above paragraphs and that Consultant has the obligation to ensure compliance with its provisions by itself and its employees, agents, and representatives. The parties have duly executed this Agreement effective as of the later date set forth below (the “Effective Date”). CONSULTANT: XXXXXXX & XXXXX ARCHITECTS, LLP By: Printed Name: Title: Authorized Representative Date: The Texas Board of Architectural Examiners, 000 Xxxxxxxxx Xx., Ste. 2-350, Austin, TX 78701, phone: (000) 000-0000, has jurisdiction over individuals licensed under the Architects Registration Law, Article 249a, Vernon’s Texas Civil Statues TRAVIS COUNTY: By: Date: Travis County Judge APPROVED AS TO PURCHASING POLICIES AND PROCEDURES: By: Xxxxxx X. Xxxxx, MBA, CPPO, CPPB Travis County Purchasing Agent AVAILABILITY OF FUNDS CONFIRMED: By: Xxxxx Xxxxx, CPA Travis County Auditor APPROVED AS TO FORM: By: Assistant County Attorney EXHIBIT 1 COMPENSATION FOR PROFESSIONAL SERVICES AND SCHEDULE OF PAYMENTS
Conflict of Interest Questionnaire. Texas Local Government Code, Chapter 176 provides information regarding conflict of interest statements to be filed by vendors. Refer to the Texas Ethics Commission website and submit information accordingly to the District’s Director of Purchasing & Warehouse Operations.
Conflict of Interest Questionnaire. Sign and upload the Conflict of Interest Questionnaire, provided as an attachment to this RFP. Additionally, Chapter 176 of the Texas Local Government Code requires vendors and consultants contracting with PSA to file a Conflict of Interest Questionnaire (CIQ) if they have an employment or other business relationship with a PSA officer or an officer's close family member. PSA is a program of the Brazos Valley Council of Governments, whose officers include: The Xxxxxxxxx Xxxxxx Xxxx, Jr., Chair The Honorable Xxxxx Xxxxxx, 1st Vice Chair The Xxxxxxxxx Xxxxx Xxxxx, 2nd Vice Chair The Xxxxxxxxx Xxxxx Xxxxx, Secretary The Xxxxxxxxx Xxxxxxx Xxxxxxx, Immediate Past Chair See attached file.
Conflict of Interest Questionnaire. If required by Chapter 176, Texas Local Government Code, Contractor shall complete and file a Conflict of Interest Questionnaire with the County Clerk, Elections Division, 0000 Xxxxxxx Xxxx., Xxxxxx, Xxxxx 00000. Contractor shall update this Questionnaire by September 1 of each year for the duration of this Contract, as required by Chapter 176 of the Local Government Code. In addition, if any statement on a submitted Questionnaire becomes incomplete or inaccurate, Contractor shall submit an updated Questionnaire. Contractor should note that the law requires the County to provide access to a filed Questionnaire on the official Travis County Internet website.
Conflict of Interest Questionnaire. Prior to commencing removal, Purchaser must complete, execute, and file with the City Secretary a Conflict of Interest Questionnaire (“Form CIQ”), a copy of which is attached to this contract as Exhibit A. This is a condition precedent to Purchaser’s entitlement to commence work, and is a requirement imposed pursuant to Texas Local Government Code, Chapter 176.
Conflict of Interest Questionnaire. If you have a conflict of interest as described in this form No FORM CIQ or the Local Government Code Chapter 176, cited therein- you are required to complete and file with TIPS, Xxxxxxx Xxxxxx, 0000 XX Xxxxxxx 000 Xxxxx, Xxxxxxxxx, Xxxxx 00000 You may find the Blank CIQ form on our website at: Copy and Paste the following link into a new browser or tab: xxxxx://xxx.xxxx-xxx.xxx/assets/documents/docs/CIQ.pdf Do you have any conflicts under this statutory requirement? 50 Filing of Form CIQ If yes (above), have you filed a form CIQ as directed here? No 51 Regulatory Standing I certify to TIPS for the proposal attached that my company is in good standing with all governmental agencies Federal or state that regulate any part of our business operations. If not, please explain in the next attribute question. Yes 52 Regulatory Standing Regulatory Standing explanation of no answer. 53 Antitrust Certification Statements (Tex. Government Code § 2155.005) By submission of this bid or proposal, the Bidder certifies that: (No Response Required) I affirm under penalty of perjury of the laws of the State of Texas that: (1) I am duly authorized to execute this contract on my own behalf or on behalf of the company, corporation, firm, partnership or individual (Company) listed below; (2) In connection with this bid, neither I nor any representative of the Company has violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15; (3) In connection with this bid, neither I nor any representative of the Company has violated any federal antitrust law; (4) Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of this bid to a competitor of the Company or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Company.
Conflict of Interest Questionnaire. 33.1 If required under Chapter 176 Texas Local Government Code, Operator shall file a completed Conflict of Interest Questionnaire in accordance with the requirements of that Chapter. Within the applicable, authorized time period prescribed in Chapter 176, Operator shall file the completed Conflict of Interest Questionnaire with the Xxxxxx County Clerk, Recording Division, 0000 Xxxxxxx Xxxx., Xxxxxx, Xxxxx 00000. Operator shall file an updated, completed questionnaire with the Xxxxxx County Clerk not later than the seventh (7th) business day after the date of an event that would make a statement in the questionnaire incomplete or inaccurate. Operator should note that the law requires that the County provide access to a filed Questionnaire on the official Xxxxxx County Internet website. However, the law does not require that the County release information which is excepted from disclosure under the Texas Public Information Act. As between County and Operator, Operator shall be solely responsible for the preparation of its Conflict of Interest Questionnaire, the accuracy and completeness of the content contained therein and ensuring compliance with all applicable requirements of Chapter 176, Local Government Code. DRAFT
