1-RFP-02-CIQ Form.pdf
PDF 560 KB Posted
- Attached to
- RFP CCTV Inspection Services State and local contract opportunity
- Solicitation number
- 25-0212
- Issued by
- Tarrant County, Texas
About this file
This document is a Conflict of Interest Questionnaire (CIQ) from the City of Fort Worth Purchasing Division for a Request for Proposals (RFP) with reference number 25-0212 for CCTV Inspection Services. The document outlines the legal requirements for vendors doing business with the local governmental entity, specifically detailing the mandatory disclosure of potential conflicts of interest under Chapter 176 of the Local Government Code. Vendors must file the questionnaire within seven days of beginning contract discussions, submitting a proposal, or becoming aware of facts that require statement disclosure.
The form requires vendors to disclose any business relationships, employment connections, or gift exchanges with local government officers that might create a potential conflict of interest. Specifically, vendors must report any relationships that involve taxable income exceeding $2,500 in a 12-month period, or gifts with an aggregate value of more than $100. The document emphasizes that compliance is an individual responsibility, and failure to properly disclose such relationships could result in a Class C misdemeanor. The Texas Ethics Commission provides the form, which must be signed and dated by the vendor, with the most recent revision dated 11/1/2021.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 4-RFP-05-Draft Vendor Services Agreement.pdf | ||
| 5-RFP-07-Questionnaire and Requirements.pdf | ||
| 8-RFP-01-Instruction to Proposers.pdf | ||
| 3-RFP-04-Reference Sheet.pdf | ||
| 2-RFP-03-Authorized Signature and Contact Details.pdf | ||
| 7-RFP-06-Evaluation Factors and Scope of Services.pdf | ||
| 6-RFP-08-Example of Contractor Inspection Submittal.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
RFP - CIQ RFP Ref. #: 25-0212 Page 1 of 3
RFP Title: CCTV Inspection Services
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
Pursuant to Chapter 176 of the Local Government Code, any person or agent of a person who contracts or seeks to contract for the sale or purchase of property, goods, or services with a local governmental entity (i.e. City of Fort Worth) must disclose in the Conflict of Interest Questionnaire Form “CIQ” the person’s affiliation or business relationship that might cause a conflict of interest with the local governmental entity. Bylaw, the Questionnaire must be filed with the City of Fort Worth Secretary no later than seven days after the date the person begins contract discussions or negotiations with the City or submits an application or response to a request for proposals or bids, correspondence, or another writing related to a potential agreement with the City. Updated Questionnaires must be filed in conformance with Chapter 176.
A copy of the Questionnaire Form CIQ is enclosed with the submittal documents.
The form is also available at https://www.ethics.state.tx.us/forms/conflict/
If you have any questions about compliance, please consult your own legal counsel.
Compliance is the individual responsibility of each person or agent of a person who is subject to the filing requirement. An offense under Chapter 176 is a Class C misdemeanor.
NOTE: If you are not aware of a Conflict of Interest in any business relationship that you might have with the City, state the Proposer name in # 1, and use N/A in each of the areas on the form. However, a signature is required in the #7 box in all cases.
https://www.ethics.state.tx.us/forms/conflict/
RFP - CIQ RFP Ref. #: 25-0212 Page 2 of 3
RFP Title: CCTV Inspection Services
RFP - CIQ RFP Ref. #: 25-0212 Page 3 of 3
RFP Title: CCTV Inspection Services
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File details come from the government source that posted it. Updated .