2-Conflict of Interest Questionnaire CIQ.pdf
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- Solicitation number
- 4063
- Issued by
- Upton County, Amarillo City, Texas
About this file
This is a Conflict of Interest Questionnaire (Form CIQ) required by the State of Texas for vendors conducting business with the Amarillo Independent School District in connection with Competitive Sealed Proposals (CSP 4063) for Roofing & HVAC Replacement services at De Zavala, Mesa Verde, and Humphrey's Highland schools. The questionnaire must be filed with the local governmental entity's records administrator no later than the seventh business day after a vendor becomes aware of facts requiring disclosure. A pre-proposal conference is scheduled for February 4, 2026, at 10:00 A.M. at the AISD Maintenance & Construction Office, with proposals due by 1:30 P.M. on February 20, 2026. Proposals may be submitted electronically through https://amaisd.bonfirehub.com/portal or as three hard copies delivered to the Amarillo ISD Purchasing Department at 7200 Interstate 40 West, Amarillo, Texas 79106. Proposals will be opened and read aloud at the AISD Education & Support Center on the deadline date.
The questionnaire requires vendors to disclose any employment or business relationships with local government officers or their family members, any taxable income arrangements with such officers outside the governmental entity, business relationships with entities in which officers hold positions or ownership interests of one percent or more, and any gifts provided to officers or their family members. Each vendor must provide a proposal guarantee of five percent of the largest possible total proposal amount in the form of a cashier's check, certified check, or bid bond payable to Amarillo ISD. Violation of disclosure requirements under Texas Local Government Code Chapter 176 constitutes a misdemeanor offense.
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Text version
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
FORM CIQ
This questionnaire reflects changes made 10 the law by H.B. 23, 84th leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1.a) with a local governmen1al entity and the vendor m88ts requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity no later than the 7th business day after the date the vendor becomes aware of facts that require the statemen to be filed. See Section 116.006(a.1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.
OFACEUSEONLY
Date Received
Name of vendor who has a business relationship with local governmental entity.
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
Name of local government officer about whom the information is being disclosed.
Name of Officer
Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?
□ Yes □No
B. Is the vendor receiving or likely to receive taxable income other than investment income, from or at the direction of the local government officer or a family member of the officer ANO the taxable income is not received from the local governmental entity?
□ Yes □No
Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more.
Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B). excluding gifts described in Section t76.003(a-l).
Signature of vendor doing business with the governmental entity
(la19
Form provided by Texas Ethics Commission www.ethics.state.1x.us Revised t/t/2021 http://www.ethics.state.1x.us/
File details come from the government source that posted it. Updated .