2-RFQt-02-CIQ Form.pdf
PDF 407 KB Posted
- Attached to
- RFQt Pipe Plug
- Solicitation number
- 25-0205
- Issued by
- Tarrant County, Texas
About this file
This document is a Conflict of Interest Questionnaire (CIQ) issued by the City of Fort Worth Purchasing Division for a Request for Quote (RFQt) titled "Pipe Plug" with reference number 25-0205. The document outlines the legal requirements for vendors doing business with the local governmental entity, specifically detailing the disclosure obligations under Chapter 176 of the Local Government Code. Vendors must disclose any business relationships or affiliations that might cause a conflict of interest with the City of Fort Worth, and the questionnaire must be filed within seven days of beginning contract discussions or submitting a proposal.
The CIQ form requires vendors to provide detailed information about potential conflicts of interest, including employment or business relationships with local government officers or their family members, gifts given to government officials, and any financial connections that exceed specified monetary thresholds. The form is part of a transparency mechanism to ensure ethical business practices and must be completed accurately, with potential legal consequences for non-compliance. An offense under this chapter is classified as a Class C misdemeanor, emphasizing the importance of full and honest disclosure by vendors seeking to do business with the City of Fort Worth.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
RFQt Ref. #: 25-0205 Doc. Ref#: RFQt-02 Page 1 of 3 RFQt Title: Pipe Plug
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. By law, 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/
RFQt Ref. #: 25-0205 Doc. Ref#: RFQt-02 Page 2 of 3
RFQt Ref. #: 25-0205 Doc. Ref#: RFQt-02 Page 3 of 3
File details come from the government source that posted it. Updated .