1-RFQt-02-CIQ Form.pdf
PDF 470 KB Posted
- Attached to
- Purchase and Installation of Detention Benches
- Solicitation number
- 25-0197
- Issued by
- Tarrant County, Texas
About this file
The document is a Conflict of Interest Questionnaire (CIQ) issued by the City of Fort Worth Purchasing Division for a Request for Quotation (RFQt) referenced as 25-0197, titled "Purchase and Installation of Detention Benches". The CIQ is a mandatory form pursuant to Chapter 176 of the Local Government Code, requiring any person or agent seeking to contract with the local governmental entity to disclose potential conflicts of interest. The form must be filed with the City of Fort Worth Secretary no later than seven days after beginning contract discussions or submitting a proposal, and updated questionnaires must be filed in conformance with the chapter.
The questionnaire requires vendors to provide detailed information about business relationships with local government officers, including any employment connections, potential taxable income, gifts, or other financial interactions that might constitute a conflict of interest. The form includes sections for vendors to declare any employment or business relationships with local government officers, any gifts given, and other potential conflicts. The document emphasizes transparency and ethical disclosure in government contracting, with specific guidelines outlined in the Local Government Code sections printed on the third page of the document.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
RFQt Ref. #: 25-0197 Doc. Ref#:RFQt-02 Page 1 of 3 RFQt Title: Purchase and Installation of Detention Benches
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/
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/
RFQt Ref. #: 25-0197 Doc. Ref#: RFQt-02 Page 2 of 3 RFQt Title: Purchase and Installation of Detention Benches
RFQt Ref. #: 25-0197 Doc. Ref#: RFQt-02 Page 3 of 3 RFQt Title: Purchase and Installation of Detention Benches
| Text3: |
| Check Box4: Off |
| Text5: |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Text12: |
| Text1: |
| Text2: |
File details come from the government source that posted it. Updated .