6-5. Conflict of Interest Form.pdf

PDF 1 MB Posted

Attached to
Interior Design Services for Arlington Air Center Fixed-Base Operator at Arlington Municipal Airport
Solicitation number
RFQ 26-0207
Issued by
Tarrant County, Austin City, Texas

About this file

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. Any person or agent seeking to contract with the City of Arlington for the sale or purchase of property, goods, or services must complete and submit the CIQ to disclose any affiliations or business relationships that might create a conflict of interest with the local governmental entity. The form requires vendors to identify themselves, disclose any relevant business relationships, and provide a signature certifying the accuracy of the information provided. If no conflict of interest exists, vendors must state "N/A" in the applicable sections while still providing a required signature.

The questionnaire is designed to ensure transparency and compliance with Texas state law governing local government procurement. Vendors are instructed to describe any employment or business relationships maintained with corporations or business entities for which City of Arlington officers or directors serve in an official capacity or hold an ownership interest of one percent or more. Updated questionnaires must be filed in conformance with Chapter 176, and the form is available through the Texas Ethics Commission website at https://www.ethics.state.tx.us/forms/conflict/. Failure to accurately complete and submit this form may result in proposal rejection or disqualification from the solicitation process.

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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 .