ESBD_455583_1758308428710_CIQ Form.pdf

CONFLICT OF INTEREST QUESTIONNAIRE

Brazosport College is required to comply with Texas Local Government Code Chapter 176, Disclosure of Certain Relationships with Local Government Officers. Any company that does business with BC must fill out a Conflict of Interest Questionnaire (CIQ) whether or not a conflict of interest exists. A conflict of interest exists in the following situations:

a. If the vendor has an employment or other business relationship with a local government officer of BC or a family member of the officer, as described by Section 176.003(a)(2)(A) of the Texas Local Government Code resulting in the officer or family member receiving taxable income; or

b. If the vendor has given a local government officer of BC or a family member of the officer one or more gifts with the aggregate value of $100, excluding any gift accepted by the officer or family member if the gift is (a) a political contribution as defined by Title 15 of the Election Code; or (b) a gift of food accepted as a guest; or;

c. If the vendor has a family relationship with a local government officer of BC.

“Vendor” means a person who enters or seeks to enter into a contract with a local governmental entity.

The term includes an agent of a vendor. The term includes an officer or employee of a state agency when that individual is acting in a private capacity to enter into a contract. The term does not include a state agency except for Texas Correctional Industries. Texas Local Government Code 176.001(7).

“Business relationship” means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on: (A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity; (B) a transaction conducted at a price and subject to terms available to the public;

or (C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency. Texas Local Government Code 176.001(3).

“Family relationship” means a relationship between a person and another person within the third degree by consanguinity or the second degree by affinity, as those terms are defined by Subchapter B, Chapter 573, Government Code. Texas Local Government Code 176.001(2-a).

“Local government officer” means: (A) a member of the governing body of a local governmental entity; (B) a director, superintendent, administrator, president, or other person designated as the executive officer of a local governmental entity; or (C) an agent of a local governmental entity who exercises discretion in the planning, recommending, selecting, or contracting of a vendor. Texas Local Government Code 176.001(4).

If no conflict of interest exists, you must type N/A on Box 1 of the CIQ form, sign, and date it.

BC Board of Regents include:

BC Board of Regents BC Officers

Robert Perryman, Chair Dr. Vincent Solis, President

Jason M. Cordoba, Vice Chairman Ginger Wooster, VP, Financial Services & CFO

Cheryl Sellers Jennifer Monical

Roland K. Hendricks Procurement

Jay Gibson Cara Green, MBA, Purchasing Manager Nita Garza Ronald Barksdale

Daniel L. Yates cgreen Highlight

Insert name of vendor seeking to do business with Brazosport College cgreen Text Box This includes the vendor name even if a conflict does not exist cgreen Line cgreen Text Box Insert name of officer with whom there is business, employment or family relationship. in no conflict, insert N/A.

cgreen Text Box Complete A-B if a conflict exist cgreen Text Box Identify and describe the relationship, if applicable cgreen Text Box Signature required -- sign and date, even if no conflict cgreen Typewritten Text Example