8-00 35 13 Conflcit of Interest Statement.pdf

This is a Conflict of Interest Statement form issued by the City of Fort Worth, Texas, for use in municipal procurement processes. The document establishes compliance requirements for all bidders, offerors, and respondents participating in City of Fort Worth contracts. Bidders must either complete a Conflict of Interest Questionnaire (CIQ) or certify that one is current and on file with the City Secretary's Office in accordance with Texas state law. The form addresses situations where members of Fort Worth City Council, the City Manager, Assistant City Managers, or City agents exercising discretion in planning, recommending, selecting, or contracting with bidders may have affiliations with a bidder's company, which may trigger the requirement for a Local Government Officer Conflicts Disclosure Statement (CIS).

The form provides three certification options for both the CIQ and CIS forms: indicating the form does not apply, confirming the form is on file with the City Secretary, or confirming the form is being provided to the City Secretary. Bidders must complete the statement by providing their company name, an authorized representative's signature, and that representative's title. The referenced forms are available through links to the Texas Ethics Commission website. This document applies to the City of Fort Worth's construction project for Comancheria Way 24 Inch Water Line (City Project Number 106854), which involves approximately 1,530 linear feet of 24-inch PVC water line installation with associated valves and infrastructure components. Bidders are advised to consult legal counsel regarding the applicability of these requirements under Texas Local Government Code Chapter 176.