11-00 35 13 Conflict of Interest Statement.pdf
PDF 157 KB Posted
- Solicitation number
- 26-0338
- Issued by
- Tarrant County, Texas
About this file
This is a Conflict of Interest Statement form required by the City of Fort Worth for bidders, offerors, and respondents participating in the 2026 CDBG Campbell Street Improvement Project (City Project No. 107033). The document outlines the conflict of interest disclosure requirements mandated by state law, specifically Texas Local Government Code Chapter 176. All bidders must either complete a current Conflict of Interest Questionnaire (CIQ) or certify that one is already on file with the City Secretary's Office. Additionally, if any member of the Fort Worth City Council, City Manager, Assistant City Manager, or a City agent with discretionary authority in the procurement process is affiliated with the bidder's company, a Local Government Officer Conflicts Disclosure Statement (CIS) may be required. The form provides three certification options for each document: that the form does not apply, that the form is current and on file with the City Secretary, or that the form is being submitted with the bid response.
The major work for this construction project includes approximately 2,500 linear feet of 7-inch curb and gutter, 3,800 square feet of 6-inch concrete driveway, 12,000 square feet of 4-inch concrete sidewalk, 4,700 square yards of 3-inch asphalt pavement (Superpave SP-D), 4,700 square yards of 11-inch pavement pulverization, 76 tons of cemlime, and 18 barrier-free ADA ramps. The project is funded through CDBG (Community Development Block Grant) resources. Bidders are urged to consult legal counsel regarding the applicability of conflict of interest forms and state law requirements to their organization.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-00 61 19 Maintenance Bond.doc | DOC document | |
| 10-00 61 14 Payment Bond.doc | DOC document | |
| 7-00 61 13 Performance Bond.doc | DOC document | |
| 5-00 21 13 Instruction to Bidders.docx | DOCX document | |
| 2-00 45 11 Bidders Prequalifications.doc | DOC document | |
| 12-Project Manual 2026 CDBG Cambell St Improvement Project CPN 107033.pdf | ||
| 13-Submission Instructions - 26-0338.docx | DOCX document | |
| 8-00 45 26 Contractor Compliance.doc | DOC document | |
| 1-00 41 00 Bid Proposal Workbook.xlsx | XLSX spreadsheet | |
| 4-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 6-00 45 13 Prequalification Application.doc | DOC document | |
| 9-00 52 43 Agreement.doc | DOC document |
Show all 12
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Text version
00 35 13 - 1
CONFLICT OF INTEREST STATEMENT
SECTION 00 35 13
CONFLICT OF INTEREST STATEMENT
Each bidder, offeror or respondent to a City of Fort Worth procurement is required to complete a Conflict of Interest Questionnaire or certify that one is current and on file with the City Secretary's Office pursuant to state law. Each bidder, offeror or respondent has a duty to review the requirements set forth in the forms and may certify, if appropriate, that the respective form does not apply.
If a member of the Fort Worth City Council, any one or more of the City Manager or Assistant City Managers, or an agent of the City who exercise discretion in the planning, recommending, selecting or contracting with a bidder, offeror or respondent is affiliated with your company, then a Local Government Officer Conflicts Disclosure Statement (CIS) may be required.
You are urged to consult with counsel regarding the applicability of these forms and Local Government Code Chapter 176 to your company.
The referenced forms may be downloaded from the links provided below.
Form CIQ (Conflict of Interest Questionnaire) Form CIS (Local Government Officer Conflicts Disclosure Statement)
� CIQ Form does not apply
� CIQ Form is on file with City Secretary
� CIQ Form is being provided to the City Secretary
� CIQ Form does not apply
� CIS Form is on File with City Secretary
� CIS Form is being provided to the City Secretary
BIDDER:
By: ___________________________________
Signature: ______________________________
Title: __________________________________
END OF SECTION
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
2026 CDBG Campbell Street Improvement Project City Project No. 107033
Revised June 5, 2026 https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf
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