6-00 35 13 Conflict of Interest Statement.doc

This is a Conflict of Interest Statement form for the City of Fort Worth's 2027 Asphalt Resurfacing Contract 3 (City Project No. 106794) located in Texas. The statement establishes disclosure requirements for all bidders, offerors, and respondents participating in the procurement. The primary work scope includes approximately 7,840 linear feet of 7" curb and gutter, 15,700 square feet of 6" concrete driveway, 709 square yards of 7" concrete valley gutter, 72,984 square yards of 3" asphalt pavement using Superpave SP-D, 72,984 square yards of 11" pavement pulverization, and 1,168 tons of cemlime.

Bidders must complete either a Conflict of Interest Questionnaire (Form CIQ) or certify that one is current and on file with the City Secretary's Office in compliance with Texas state law. If any member of the Fort Worth City Council, City Manager, Assistant City Manager, or City agent with discretionary authority in the planning, recommendation, selection, or contracting process is affiliated with the bidder's company, a Local Government Officer Conflicts Disclosure Statement (Form CIS) may be required. Bidders are required to certify their compliance status by selecting the appropriate checkbox indicating whether the applicable form does not apply, is on file with the City Secretary, or is being provided to the City Secretary. The document advises bidders to consult legal counsel regarding the applicability of these requirements under Texas Local Government Code Chapter 176.