4-5. Conflict of Interest Form.pdf

This document is a Conflict of Interest Questionnaire (CIQ) form from the City of Arlington, Texas, Office of Procurement, required pursuant to Chapter 176 of the Local Government Code. The CIQ must be completed and submitted by any person or entity seeking to contract with the City of Arlington for the sale or purchase of property, goods, or services. The form requires vendors to disclose any affiliations or business relationships that might create conflicts of interest with the City. Proposers must complete the questionnaire by providing their name, identifying any officers of the City with whom they have business relationships, and describing any employment or business relationships maintained with corporations or entities in which City officials serve as officers, directors, or hold ownership interests of one percent or more. If no conflicts of interest exist, vendors must state "N/A" in the applicable sections while providing their company name and signature in the designated areas.

A signature is mandatory in all cases, regardless of whether conflicts of interest are identified. The CIQ form is available through the Texas Ethics Commission website at https://www.ethics.state.tx.us/forms/conflict/, and updated questionnaires must be filed in conformance with Chapter 176. The form contains multiple checkboxes and text fields to document specific conflict scenarios. Submission of an accurate and complete CIQ is a requirement for bid consideration in this contract opportunity for the Annual Requirements Contract for Cold Patch Asphalt with the City of Arlington.