3-RFQt-02-CIQ Form.docx
DOCX document 336 KB Posted
- Attached to
- RFQt Weapon Wipes and Needle Oilers
- Solicitation number
- 25-0200
- 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 solicitation regarding Weapon Wipes and Needle Oilers. The procurement is identified as ITB Reference #24-00NN and RFQt Reference #25-0200, with the City of Fort Worth seeking bids for police department equipment on an "as needed" basis. The document outlines mandatory disclosure requirements for potential vendors under Chapter 176 of the Local Government Code, specifically detailing the legal obligation for persons or agents seeking to contract with the local governmental entity to disclose potential conflicts of interest.
The CIQ requires vendors to complete and submit a questionnaire documenting any business relationships that might create a conflict of interest with the City of Fort Worth. Failure to comply or file the required documentation can result in a Class C misdemeanor. Vendors must submit the completed form within seven days of initiating contract discussions, submitting a proposal, or responding to a bid. The form must be filed with the City Secretary, and vendors are advised to consult their legal counsel if they have questions about compliance. The questionnaire is available online through the Texas Ethics Commission website, and even if no conflicts exist, vendors must still complete and sign the document.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
| ITB - QUESTIONNAIRE |
| ITB Ref. #: 24-00NN |
| Page 1 of 1 |
ITB Title:___________________________________________________________
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
| RFQt Ref. #: 25-0200 |
| Doc. Ref#: RFQt-02 |
| Page 1 of 15 |
RFQt Title: Weapon Wipes and Needle Oilers
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. 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.
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File details come from the government source that posted it. Updated .