2-RFP-02-CIQ Form.pdf
PDF 569 KB Posted
- Attached to
- RFP Library Materials Dispenser
- Solicitation number
- 25-0195
- Issued by
- Tarrant County, Texas
About this file
This document is a Conflict of Interest Questionnaire (CIQ) for the City of Fort Worth Purchasing Division, specifically for a Request for Proposals (RFP) related to a Library Materials Dispenser, with the RFP reference number 25-0195. The document outlines the legal requirements under Chapter 176 of the Local Government Code for vendors doing business with the local governmental entity. Any person or agent seeking to contract with the City of Fort Worth must disclose potential conflicts of interest and file the CIQ form within seven days of beginning contract discussions or submitting a proposal.
The CIQ form requires vendors to provide detailed information about their business relationships with local government officials, including potential financial interactions, gifts, or employment connections that might create a conflict of interest. The form must be completed and signed, even if no conflicts exist, with the vendor instructed to use "N/A" if there are no reportable relationships. Failure to file the questionnaire or knowingly providing incomplete information can result in a Class C misdemeanor. The Texas Ethics Commission provides the form, which is designed to ensure transparency and prevent potential conflicts of interest in local government contracting processes.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
RFP - CIQ RFP Ref. #: 25- Page 1 of 3
RFP Title: Library Materials Dispenser
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/
If you have any questions about compliance, please consult your own legal counsel.
Compliance is the individual responsibility of each person or agent of a person who is subject to the filing requirement. An offense under Chapter 176 is a Class C misdemeanor.
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.
RFP - CIQ RFP Ref. #: 25-0195 Page 2 of 3
RFP Title: Library Materials Dispenser_
RFP - CIQ RFP Ref. #: 25-0195 Page 3 of 3
RFP Title:Library Materials Dispenser
File details come from the government source that posted it. Updated .