4-5. 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 for any person or agent seeking to contract or conduct business with the municipality. The form mandates disclosure of affiliations or business relationships that could create conflicts of interest in accordance with Chapter 176 of the Texas Local Government Code. Vendors must complete the questionnaire and identify any employment or business relationships maintained with corporations or entities in which a local government officer serves as an officer, director, or holds an ownership interest of one percent or more. The form includes designated sections for vendor name, officer name, and detailed descriptions of any relevant business relationships. If no conflict of interest exists, vendors must state the proposer name in section one and enter "N/A" in applicable areas, though a signature remains mandatory in all cases.

The questionnaire form is available through the Texas State Ethics Commission website at https://www.ethics.state.tx.us/forms/conflict/ and must be submitted with all solicitation responses. This particular CIQ is associated with the City of Arlington's Annual Requirements Contract for Fill Materials for the Water Utilities Department. The City of Arlington emphasizes that all solicitations are distributed exclusively through Euna Procurement, and bids may be submitted electronically or in sealed paper envelopes labeled with the company name, solicitation number, and title. Late bids will not be accepted, and the City assumes no responsibility for incomplete specifications or addendums received through unofficial channels.