2-RFP-02-CIQ Form.pdf
PDF 425 KB Posted
- Attached to
- RFP Generator Maintenance
- Solicitation number
- 25-0248
- 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) related to Generator Maintenance Services, with the RFP Reference Number 25-0248. The document outlines the legal requirements for vendors doing business with local governmental entities, specifically addressing the disclosure of potential conflicts of interest as mandated by Chapter 176 of the Local Government Code. Vendors are required to file this questionnaire within seven days of beginning contract discussions or submitting a proposal, and must update the form if any changes occur.
The form requires vendors to disclose any business relationships, employment connections, or potential financial interests involving local government officers or their family members. Key disclosure points include whether the vendor or a family member might receive taxable income from the local government entity, maintains a business relationship with a corporation where a local government officer serves, or has given gifts to a local government officer. The document emphasizes that compliance is the individual responsibility of each vendor, and failure to properly disclose potential conflicts can result in a Class C misdemeanor. The form is provided by the Texas Ethics Commission and was revised in November 2021.
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Other files
| File | Type | Posted |
|---|---|---|
| 6-RFP-06-Draft Vendor Service Agreement (SB Goal).docx | DOCX document | |
| 7-RFP-07-Deviations.xlsx | XLSX spreadsheet | |
| 1-RFP-01-Instruction to Proposers.pdf | ||
| 5-Attachment B.xlsx | XLSX spreadsheet | |
| 8-RFP-03-Authorized Signature and Questionnaire.pdf | ||
| 9-RFP-08-Small Business Utilization Form V1.pdf | ||
| 10-RFP-09-Discount Calculator.xlsx | XLSX spreadsheet | |
| 11-RFP-02-Scope of Services.pdf | ||
| 4-Attachment A.docx | DOCX document | |
| 3-RFP-04-Reference Sheet.pdf |
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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 |
| Text2: |
| Text3: |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Text10: |
| Text1: 0248 |
| Text4: Generator Maintenance Services |
| Text5: 0248 |
| Text6: Generator Maintenance Services |
| Text7: 0248 |
| Text8: Generator Maintenance Services |
File details come from the government source that posted it. Updated .