3-RFQt-02-CIQ Form.pdf
PDF 407 KB Posted
- Attached to
- RFQt Sign Sheeting Material State and local contract opportunity
- Solicitation number
- 25-0221
- 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 Quotation (RFQt) related to Sign Sheeting Material, with the reference number 25-0221. The document outlines the legal requirements for vendors doing business with local governmental entities, specifically detailing the disclosure obligations under Chapter 176 of the Local Government Code. Vendors must complete and file this questionnaire within seven days of beginning contract discussions, submitting a proposal, or responding to a request for proposals or bids.
The CIQ form requires vendors to disclose any potential conflicts of interest, including employment or business relationships with local government officers or their family members. Key considerations include reporting any business relationships that might result in taxable income exceeding $2,500 in a 12-month period, or any gifts to government officers valued over $100. The form must be filed with the local government entity's records administrator, and failure to comply can result in a Class C misdemeanor. The questionnaire is designed to ensure transparency and prevent potential conflicts of interest in government procurement processes.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 2-RFQt-04-Standard Purchasing Terms and Conditions.pdf | ||
| 1-RFQt-01-Instructions to Bidders.pdf | ||
| 4-RFQt-03-Authorized Signature and Contact Details.pdf | ||
| 5-RFQt-05-Specifications.pdf | ||
| 6-RFQt-06-Questionnaire and Requirements.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
RFQt Ref. #: 25-0221 Doc. Ref#: RFQt-02 Page 1 of 3 RFQt Title: Sign Sheeting Material
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. #: 25-0221 Doc. Ref#: RFQt-02 Page 2 of 3
RFQt Ref. #: 25-0221 Doc. Ref#: RFQt-02 Page 3 of 3
File details come from the government source that posted it. Updated .