7-00 35 13 Conflict of Interest Statement 106067.pdf
PDF 86 KB Posted
- Solicitation number
- 25-0097
- Issued by
- Tarrant County, Frankston Town, Texas
About this file
This is a Conflict of Interest Affidavit form required for bidders on the City of Fort Worth's Sanitary Sewer Main Replacements Contract 2025, identified as City Project No. 106067. The document outlines the mandatory conflict of interest disclosure requirements that all bidders, offerors, or respondents must complete when participating in City of Fort Worth procurements, including either completing a Conflict of Interest Questionnaire (CIQ) or certifying that a current one is on file with the City Secretary's Office pursuant to state law. Additionally, if any Fort Worth City Council member, City Manager, Assistant City Managers, or City agents with discretionary authority in the procurement process are affiliated with the bidding company, a Local Government Officer Conflicts Disclosure Statement (CIS) may be required under Local Government Code Chapter 176.
The form provides checkboxes for bidders to indicate the status of their required filings, including whether CIQ and CIS forms are on file with the City Secretary, being provided to the City Secretary, or if the CIS form does not apply to their situation. The document includes links to download the necessary forms from the Texas Ethics Commission website and requires the bidder's company information, authorized signature, address, and title of the signatory. This affidavit serves as a compliance document to ensure transparency and prevent conflicts of interest in the city's procurement process for the sanitary sewer infrastructure project.
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Text version
00 35 13
CONFLICT OF INTEREST AFFIDAVIT
SECTION 00 35 13
CONFLICT OF INTEREST STATEMENT
Each bidder, offeror or respondent to a City of Fort Worth procurement is required to complete a Conflict of Interest Questionnaire or certify that one is current and on file with the City Secretary’s Office pursuant to state law.
If a member of the Fort Worth City Council, any one or more of the City Manager or Assistant City Managers, or an agent of the City who exercises discretion in the planning, recommending, selecting or contracting with a bidder, offeror or respondent is affiliated with your company, then a Local Government Officer Conflicts Disclosure Statement (CIS) may be required.
You are urged to consult with counsel regarding the applicability of these forms and Local Government Code Chapter 176 to your company.
The referenced forms may be downloaded from the links provided below.
https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf
CIQ Form is on file with City Secretary
CIQ Form is being provided to the City Secretary
CIS Form does not apply
CIS Form is on File with City Secretary
CIS Form is being provided to the City Secretary
BIDDER:
By:
Company (Please Print)
Signature:
Address
Title:
City/State/Zip (Please Print)
END OF SECTION
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised February 24, 2020
SANITARY SEWER MAIN REPLACEMENTS
CONTRACT 2025
City Project No. 106067 http://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf https://www.ethics.state.tx.us/data/forms/conflict/CIS.pdf
| SECTION 00 35 13 |
| BIDDER: |
| END OF SECTION |
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