5-5. Conflict of Interest Form.pdf
PDF 1 MB Posted
- Solicitation number
- 26-0205
- Issued by
- Tarrant County, Austin City, Texas
About this file
This is a Conflict of Interest Questionnaire (CIQ) form required by the City of Arlington, Texas, for vendors seeking to contract with the municipality. The form complies with Chapter 176 of the Local Government Code and requires any person or agent bidding on goods, services, or property with the City of Arlington to disclose affiliations or business relationships that might create conflicts of interest. The specific solicitation involves the purchase of two large-scale autonomous electric mower systems capable of maintaining sports turf facilities while minimizing environmental impact and reducing operational costs. The City encourages electronic submission through its Bonfire platform, though paper bids in sealed envelopes are accepted. Late bids will not be accepted, and bidders are cautioned that solicitations received through channels other than Bonfire may be incomplete, potentially rendering submissions non-compliant.
The CIQ form requires vendors to identify themselves in Section 1 and disclose any employment or business relationships maintained with corporations or entities where local government officers serve as officers, directors, or hold ownership interests of one percent or more. Vendors unaware of conflicts of interest must state "N/A" in applicable areas while providing a required signature. The form serves as a disclosure mechanism to ensure transparency and prevent improper relationships that could influence the procurement process. No specific pricing information, set-asides, or award timelines are referenced in this CIQ document, as it functions solely as a compliance and disclosure instrument within the broader solicitation package.
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Text version
CITY OF ARLINGTON - OFFICE OF PROCUREMENT
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
CONFLICT OF INTEREST QUESTIONNAIRE (CIQ)
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 Arlington) 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. 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/
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/
Project Number: Page 2 of 3 Project Title:
| CONFLICT OF INTEREST QUESTIONNAIRE (CIQ) |
| 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 ca... |
| Project Title: |
| lJ Nlame ot vendor who has b11siness retatianshipwiU1 locrl govemmemal Qnlity: |
| Name oi Officer: |
| w Describe each employment or busi11ess 1Nlaticmshp th 1 the VQndor 1named in Section 1 mai11tai11s wilh a corporation or o1her business Qn1i1y wi1h respect to wihich 1he local govemment officer serves as 11 offioer or directo or holds 11n ownership interest of ooo pefcent or more: |
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
File details come from the government source that posted it. Updated .