13-4 Conflict of Interest Form.pdf

This is a Conflict of Interest Questionnaire (CIQ) form issued by the City of Arlington, Texas Office of Procurement, required pursuant to Chapter 176 of the Local Government Code. The form must be completed by any person or agent seeking to contract with the City of Arlington for the sale or purchase of property, goods, or services. The CIQ requires disclosure of any affiliation or business relationship that might cause a conflict of interest with the local governmental entity. Bidders who are not aware of any conflicts of interest must state the proposer name in Section 1, use "N/A" in each relevant area of the form, and provide a signature in Section 7. The form requests identification of vendors with business relationships to the City, names of City officers involved, and detailed descriptions of employment or business relationships that vendors maintain with corporations or business entities in which local government officers serve as officers, directors, or hold ownership interests of one percent or more.

The questionnaire applies to the Driveway and Paving Improvements project for Arlington Fire Department Station 15 located at 906 Eden Rd, Arlington, TX 76001. This project involves removal and disposal of existing concrete pavement, sidewalks, and curbs, with replacement by new concrete pavement, sidewalks, and curbs, including preparation and installation of required base and subgrade. All work must comply with project plans and specifications prepared by Simon Engineering & Consulting dated February 11, 2026. The City of Arlington requires electronic submission of bids through Euna Procurement and will not accept late submissions. The CIQ form is available at https://www.ethics.state.tx.us/forms/conflict/ and must be completed and signed by all bidders regardless of whether conflicts of interest exist.