2-RFP-02-CIQ Form.pdf
PDF 425 KB Posted
- Attached to
- RFP Call Center Monitoring Services
- Solicitation number
- 25-0189
- Issued by
- Tarrant County, Texas
About this file
This document is a Conflict of Interest Questionnaire (CIQ) from the City of Fort Worth Purchasing Division for a Request for Proposals (RFP) for Call Center Monitoring Services, with the RFP Reference Number 25-0189. The document outlines the legal requirements for vendors doing business with the local governmental entity, specifically pursuant to Chapter 176 of the Local Government Code. Vendors are required to disclose any business relationships or potential conflicts of interest within seven days of beginning contract discussions or submitting a proposal.
The CIQ form requires vendors to provide detailed information about any business relationships with local government officers, including potential taxable income, gifts, or employment connections that might create a conflict of interest. The form must be completed and filed with the City of Fort Worth Secretary, even if no conflicts exist, with the requirement that the vendor's signature is mandatory in the final section. The document emphasizes that compliance is the individual responsibility of each person or agent seeking to contract with the local governmental entity, and failure to properly disclose potential conflicts could result in a Class C misdemeanor.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
RFP - CIQ RFP Ref. #: 25- Page 1 of 3
RFP Title:_________________________________________________________
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.
https://www.ethics.state.tx.us/forms/conflict/
RFP - CIQ RFP Ref. #: 25- Page 2 of 3
RFP Title:_________________________________________________________
RFP - CIQ RFP Ref. #: 25- Page 3 of 3
RFP Title:_________________________________________________________
| Check Box1: Off |
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| Check Box4: Off |
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| Check Box7: Off |
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| Text10: |
| Text1: 0189 |
| Text4: Call Center Monitoring Services |
| Text5: 0189 |
| Text6: Call Center Monitoring Services |
| Text7: 0189 |
| Text8: Call Center Monitoring Services |
File details come from the government source that posted it. Updated .