3-RFQt-02-CIQ Form.pdf
PDF 407 KB Posted
- Attached to
- RFQt Wildlife Removal and Dam Deconstruction
- Solicitation number
- 25-0214
- 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) titled "Wildlife Removal and Dam Deconstruction" with reference number 25-0214. The CIQ is a mandatory form pursuant to Chapter 176 of the Local Government Code, which requires any person or agent seeking to contract with a local governmental entity to disclose potential conflicts of interest. The form must be filed with the City of Fort Worth Secretary no later than seven days after beginning contract discussions or submitting a proposal, and updated questionnaires are required to maintain compliance.
The document outlines the legal requirements for vendors doing business with local government entities, specifically detailing various scenarios that might constitute a conflict of interest. These include business relationships where a vendor or their family members might receive taxable income from the local government, have given gifts to government officers, or maintain business relationships with corporations where government officers serve in leadership roles. The form emphasizes that failure to properly disclose potential conflicts can result in a Class C misdemeanor, and compliance is the individual responsibility of each person or agent subject to the filing requirement.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
RFQt Ref. #: 25-0214 Doc. Ref#: RFQt-02 Page 1 of 3 RFQt Title: Wildlife Removal and Dam Deconstruction
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. #: 25-0214 Doc. Ref#: RFQt-02 Page 2 of 3
RFQt Ref. #: 25-0214 Doc. Ref#: RFQt-02 Page 3 of 3
File details come from the government source that posted it. Updated .