2-00 35 13 Conflict of Interest Statement 106066.pdf
PDF 120 KB Posted
- Attached to
- PW ITB - 106066 - Small Diameter Water Main Extensions, Replacements, and Relocations Contract 2025
- Solicitation number
- 25-0093
- Issued by
- Tarrant County, Texas
About this file
This is a Conflict of Interest Affidavit form for the City of Fort Worth's Small Diameter Water Main Extensions, Replacements & Relocations Contract 2025, identified as City Project No. 106066 and dated February 24, 2020. The document serves as Section 00 35 13 of the standard construction specification documents and requires all bidders, offerors, or respondents to complete conflict of interest documentation as mandated by state law. The form does not specify project quantities, response dates, award dates, or contract terms, as it functions solely as a compliance requirement for the procurement process.
The form requires bidders to either complete a Conflict of Interest Questionnaire (CIQ) or certify that one is current and on file with the City Secretary's Office, and potentially submit a Local Government Officer Conflicts Disclosure Statement (CIS) if any Fort Worth City Council members, City Managers, Assistant City Managers, or City agents with procurement discretion are affiliated with the bidder's company. The document provides checkboxes for bidders to indicate the status of their CIQ and CIS forms and includes links to download the required forms from the Texas Ethics Commission website. No specific funding amounts, set-asides, or incumbent information is provided, as this document focuses exclusively on ethical compliance requirements for the bidding process.
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Text version
CITY OF FORT WORTH SMALL DIAMETER WATER MAIN EXTENSIONS,
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS REPLACEMENTS & RELOCATIONS CONTRACT 2025 Revised February 24, 2020 City Project No. 106066
00 35 13
CONFLICT OF INTEREST AFFIDAVIT
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.
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 exercises 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.
https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf
□ CIQ Form does not apply
□ CIQ Form is on file with City Secretary
□ CIQ Form is being provided to the City Secretary
□ CIS Form does not apply
□ CIS Form is on File with City Secretary
□ CIS Form is being provided to the City Secretary
BIDDER:
By:
Company (Please Print)
Signature:
Address
Title:
City/State/Zip (Please Print)
END OF SECTION
http://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf
| SECTION 00 35 13 |
| BIDDER: |
| END OF SECTION |
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