3-RFQt-02-CIQ Form.pdf
PDF 407 KB Posted
- Attached to
- RFQt Large Printer Ink State and local contract opportunity
- Solicitation number
- 25-0230
- Issued by
- Tarrant County, Texas
About this file
This is a Conflict of Interest Questionnaire (CIQ) document from the City of Fort Worth Purchasing Division for RFQt #25-0230 titled "Large Printer Ink." The document serves as a mandatory disclosure form that vendors must complete when contracting or seeking to contract with the City of Fort Worth for the sale or purchase of property, goods, or services. The questionnaire must be filed with the City of Fort Worth Secretary no later than seven days after the vendor begins contract discussions, negotiations, or submits an application or response to requests for proposals or bids.
The CIQ form is required pursuant to Chapter 176 of the Local Government Code and mandates disclosure of any business relationships or affiliations that might cause a conflict of interest with the local governmental entity. The document provides instructions for vendors who are not aware of any conflicts of interest to state the proposer name in section 1 and use "N/A" in other areas, while still requiring a signature in section 7. Non-compliance with Chapter 176 constitutes a Class C misdemeanor, and the form is available online through the Texas Ethics Commission website. The questionnaire includes sections for identifying local government officers, describing employment or business relationships, detailing corporate connections, and disclosing any gifts provided to government officials.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-RFQt-01-Instructions to Bidders.pdf | ||
| 5-RFQt-06-Questionnaire and Requirements.pdf | ||
| 6-RFQt-05-Specifications.pdf | ||
| 2-RFQt-04-Standard Purchasing Terms and Conditions.pdf | ||
| 4-RFQt-03-Authorized Signature and Contact Details.pdf | ||
| 7-Submission Instructions - 25-0230.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
RFQt Ref. #: 25-0230 Doc. Ref#: RFQt-02 Page 1 of 3 RFQt Title: Large Printer Ink
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. #: 25-0230 Doc. Ref#: RFQt-02 Page 2 of 3
RFQt Ref. #: 25-0230 Doc. Ref#: RFQt-02 Page 3 of 3
File details come from the government source that posted it. Updated .