4-4 Conflict of Interest Form.pdf

This is a Conflict of Interest Questionnaire (CIQ) form issued by the City of Arlington, Texas, Office of Procurement, required pursuant to Chapter 176 of the Local Government Code. The form must be completed by any person or entity seeking to contract with the City of Arlington for the sale or purchase of property, goods, or services. The document serves as a disclosure mechanism for identifying potential conflicts of interest arising from business relationships or affiliations between the proposer and the City. Bidders responding to the Request for Proposals for Water Risk Assessment Analysis—a machine learning-based solution for assessing water main network risk exposure managed by Arlington Water Utilities—must submit a completed CIQ form as part of their proposal package. The form requires proposers to identify their company name, disclose any employment or business relationships with corporations or entities in which a City officer or director holds an ownership interest of one percent or more, and obtain authorized signature certification.

If a proposer has no known conflicts of interest with the City, the form may be submitted with "N/A" entries in the disclosure sections; however, a signature is required in all cases regardless of conflict status. The completed CIQ form must be filed in conformance with Chapter 176 of the Local Government Code. The official form is available through the Texas Ethics Commission website at https://www.ethics.state.tx.us/forms/conflict/. Proposers are strongly encouraged to submit responses electronically through Bonfire, the City's exclusive platform for solicitation notification and dissemination, to ensure receipt of complete specifications and any addendums. Paper submissions must be enclosed in sealed envelopes labeled with the company name, solicitation number, and title, with late proposals subject to rejection.