RFP _ 25-26-10 Gasoline and Diesel Fuel.pdf

Hidalgo Independent School District 309 E. Flora Ave.

Hidalgo, TX. 78557

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REQUEST FOR PROPOSALS

RFP NO. RFP # 25-26-10

Gasoline and Diesel Fuel

Hidalgo, TX. 78557

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REQUEST FOR PROPOSALS (RFP) FOR

RFP # 25-26-10

GASOLINE AND DIESEL FUEL

PROCUREMENT INFORMATION

PURPOSE

GENERAL

SCOPE OF SERVICES

SUBMITTAL REQUIREMENTS

SELECTION PROCESS

ATTACHMENT

Hidalgo, TX. 78557

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Procurement Information

1. INTENTION: It is the intention of the Board of Trustees of Hidalgo Independent School District to receive proposals from interested vendors to select vendor (s) offering the best value for Gasoline and Diesel Fuel.

Proposals will be received at:

Hidalgo ISD RFP # 25-26-10 Gasoline and Diesel Fuel Attn: Edward Gonzales - Purchasing Department 309 E. Flora Ave.

Hidalgo, Texas 78557

The proposals are due on Thursday, August 13, 2026, at 1:00 pm. One original copy with a USB.

The specifications and a general description of the Gasoline and Diesel Fuel can be picked up at the district or downloaded from the school district website at https://www.hidalgo-isd.org at Departments > Purchasing> Bids & RFP’s

2. CONTACT: Please call Mr. Edward Gonzales, Director of Purchasing at 956-843-4416 or email to edgonzales@hidalgo-isd.org if you have any questions regarding this proposal.

3. CONTRACT SERVICE PERIOD: This is a term contract beginning on September 1, 2026, or soon thereafter and ending on August 31, 2027. The contract will be put into effect by means of a purchase order(s) executed by the Hidalgo ISD Business Office after bids have been awarded. Any additional agreements/contracts to be signed by Hidalgo ISD shall be included with the bid.

4. RENEWAL CLAUSE: This contract may be renewed for an additional two (2) additional one-year periods, subject to Board Approval.

5. EEOC NON-DISCRIMINATION STATEMENT: It is the policy of Hidalgo ISD not to discriminate on the basis of sex, age, handicap, religion, race, color or national origin in its educational programs.

6. PAYMENT INFORMATION: Payment will be made on the District’s regular payment schedule.

7. TERMS: Net 30 unless otherwise noted as an exception.

8. PRICE: Your PRICE must remain firm during the term of the contract period. The district has the option to increase or decrease the estimated quantities by 100%.

9. DELIVERY INFORMATION: Deliveries shall be made at the Transportation Department 1111 E. Pirate Drive, Hidalgo, Texas 78557. The Transportation Department will be placing orders as needed from the awarded vendor(s) following school board approval.

10. RIGHT TO AWARD PROPOSALS: The Hidalgo ISD reserves the right to accept or reject any or all proposals. HISD further reserves the right to award one or more contracts, in part or in whole, to a single or to multiple prospective vendors.

11. ADDENDUMS: It will be the vendor’s responsibility to check Hidalgo ISD Purchasing website for any addendums or additional information. The website is www.hidalgo-isd.org if you have any questions, please contact the purchasing Office and we will assist you.

https://www.hidalgo-isd.org/ mailto:edgonzales@hidalgo-isd.org http://www.hidalgo-isd.org/

Hidalgo, TX. 78557

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PURPOSE

(1) Hidalgo Independent School District (HISD) is solicitating sealed proposals from qualified, experienced vendors for the purchase and delivery of Gasoline and Diesel Fuel.

RFP # 25-26-10

GASOLINE AND DIESEL FUEL

INTENT

(2) Hidalgo ISD is seeking proposals from qualified vendors for gasoline and diesel fuel. The company will be used to supply Gasoline and Fuel on an as needed basis. Hidalgo ISD reserves the right to select one or more proposers for these products. Hidalgo ISD transportation Department will be placing the orders as needed. Quantity may increase or decrease.

SUBMITTAL OF RFP

(3) RFPs shall be submitted in sealed envelopes as called referenced on the attached solicitation. One (1) complete sets of the response one (1) original marked “ORIGINAL,” and one (1) marked “COPY with a USB in your proposal. RFP’s submitted by facsimile (fax) or electronically shall NOT be accepted. Submittal of an RFP in response to this solicitation constitutes an offer by the respondent. Once submitted, RFP’s become the property of the Hidalgo I.S.D. and as such the Hidalgo ISD reserves the right to use any ideas contained in any RFP regardless of whether that respondent/firm is selected. Submission of a RFP in response to this solicitation, by any respondent, shall indicate that the respondent(s) has/have accepted the conditions contained in the RFP, unless clearly and specifically noted in the RFP submitted and confirmed in the contract between the Hidalgo ISD and the successful respondent otherwise. RFPs which do not comply with these requirements may be rejected at the option of the Hidalgo I.S.D. RFPs must be filed with the Hidalgo I.S.D.

before the deadline day and hour. No late RFPs will be accepted. They will be returned to respondent unopened (if properly identified). Failure to meet RFP requirements may be grounds for disqualification.

If Mailing, Hand Delivered, Land Courier (Fed Ex/UPS, Etc.):

Hidalgo I.S.D.

RFP # 25-26-10 Gasoline and Diesel Fuel Edward Gonzales Director of Purchasing 309 E. Flora Ave.

Hidalgo, Tx 78557

HIDALGO I.S.D CONTACT

If you should have any questions regarding the preparation of the RFP contact Edward Gonzales, Director of Purchasing at (956) 843-4416 or edgonzales@hidalgo-isd.org.

TIME ALLOWED FOR ACTION TAKEN

(4) The Hidalgo I.S.D. may hold RFP/s 60 days after deadline without taking action. Respondents are required to hold their RFP/s firm for same period of time.

RIGHT TO REJECT/AWARD

(5) The Hidalgo I.S.D. reserves the right to reject any or all RFPs, to waive any or all formalities or technicalities, and to make such awards of contract as may be deemed to be the best and most advantageous to the Hidalgo I.S.D.

mailto:edgonzales@hidalgo-isd.org

Hidalgo, TX. 78557

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ASSIGNMENT

(6) Respondents are advised that the Hidalgo I.S.D. shall not allow the successful respondent to sell, assign, transfer, or convey any part of any contract resulting from this RFP in whole or in part, to a third party without the written approval of the Hidalgo I.S.D.

AWARD

(7) Respondents are advised that the Hidalgo I.S.D. is soliciting RFPs and award shall be made to the respondents that is the best and most advantageous to Hidalgo I.S.D.

NUMBER OF CONTRACTS

(8) The HIDALGO ISD reserves the right to award one, more than one, or no contract(s) in response to this

RFP.

ALTERATIONS/AMENDMENTS TO RFP

(9) RFP CANNOT be altered or amended after opening time. Alterations made before opening time must be initialed by respondent guaranteeing authentic Hidalgo ISD. No RFP may be withdrawn after opening time without acceptable reason in writing and only after approval by the Hidalgo I.S.D.

LIST OF EXCEPTIONS

(10) The respondent shall attach to his/her RFP a list of any exceptions to the specifications/ requirements.

RESPONDENT’S EMPLOYEES

(11) Neither the Respondent nor his/her employees engaged in fulfilling the terms and conditions of this Service Contract shall be considered employees of the Hidalgo ISD. The method and manner of performance of such undertakings shall be under the exclusive control of the vendor on contract. The Hidalgo ISD shall have the right of inspection of said undertakings at any time.

INTERPRETATIONS

(12) Any questions concerning the project and/or specifications/requirements with regards to this solicitation for statement(s) of qualifications shall be directed to the designated individuals as outlined in the RFP. Such interpretations, which may affect the eventual outcome of this request for statements of qualifications, shall be furnished in writing to all prospective Respondents via Addendum. No interpretation shall be considered binding unless provided in writing by the Hidalgo I.S.D. in accordance with paragraph entitled “Addenda and Modifications”.

CONFIDENTIAL INFORMATION

(13) Any information deemed to be confidential by the respondent should be clearly noted on the pages where confidential information is contained; however, the Hidalgo ISD cannot guarantee that it will not be compelled to disclose all or part of any public record under Texas Public Information Act, since information deemed to be confidential by the respondent may not be considered confidential under Texas Law, or pursuant to a Court order.

PAST PERFORMANCE

(14) Respondent’s past performance shall be taken into consideration in the evaluation of RFP submittal.

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JURISDICTION

(15) Contract(s) executed as part of this solicitation shall be subject to and governed under the laws of the State of Texas. Any and all obligations and payments are due and performable and payable in Hidalgo County, Texas.

VENUE

(16) The parties agree that venue for purposes of any and all lawsuits, cause of action, arbitration, and/or any other dispute(s) shall be in Hidalgo County, Texas.

CONFLICT OF INTEREST

(17) CHAPTER 176 OF THE TEXAS LOCAL GOVERNMENT CODE Effective January 1, 2006, Chapter 176 of the Texas Local Government Code requires that any vendor or person considering doing business with a local government entity disclose in the Questionnaire Form CIQ, the vendor or person’s affiliation or business relationship that might cause a conflict of interest with a local government entity. By law, this questionnaire must be filed with the records administrator of the Hidalgo I.S.D. not later than the 7th business day after the date the person becomes aware of facts that require the statement be filed. See Section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. For more information or to obtain Questionnaire CIQ visit the Texas Ethics Commission web page at www.ethics.state.tx.us/forms/CIQ.pdf.

IF YOU HAVE ANY QUESTIONS ABOUT COMPLIANCE, PLEASE CONSULT YOUR OWN LEGAL

COUNSEL. COMPLIANCE IS THE INDIVIDUAL RESPONSIBILITY OF EACH PERSON OR AGENT OF A

PERSON WHO IS SUBJECT TO THE FILING REQUIREMENT. AN OFFENSE UNDER CHAPTER 176 IS

A CLASS “C” MISDEMEANOR.

CONFIDENTIALITY OF INFORMATION AND SECURITY

(18) Should the successful respondent become the holder of and have access to confidential information in the process of fulfilling its responsibilities in connection with an awarded contract the successful respondent agrees that it shall keep such information confidential and will comply fully with the laws and regulations of the State of Texas, ordinances and regulations of the Hidalgo ISD, and any applicable federal laws and regulations relating to confidentiality.

TERMINATION OF CONTRACT

(19) The Hidalgo I.S.D. reserves the right to terminate the contract if, in the opinion of the Hidalgo I.S.D., the successful vendor’s performance is not acceptable, no funds are available, or if the Hidalgo ISD wishes, without cause, to discontinue this contract. Termination will be in written form allowing a 30-day notice.

http://www.ethics.state.tx.us/forms/CIQ.pdf http://www.ethics.state.tx.us/forms/CIQ.pdf

Hidalgo, TX. 78557

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RESPONSE DEADLINE

(20) Responses to the RFP must be addressed to Edward Gonzales, Director of Purchasing, Hidalgo I.S.D., 309 E. Flora Ave. Hidalgo, Tx 78557 by Thursday, August 13, 2026, until 1:00 p.m. for consideration. An original and one (1) complete sets along with a USB of the response must be submitted no later than this date and time in a sealed envelope indicating that its contents are in response to the RFP for “GASOLINE AND DIESEL FUEL)”. Respondents are advised that all confidential records must be submitted in a separate sealed envelope and marked accordingly.

If Mailing, Hand Delivered, Land Courier (Fed Ex/UPS, Etc.):

Hidalgo I.S.D.

RFP # 25-26-10 Gasoline and Diesel Fuel Edward Gonzales Director of Purchasing 309 E. Flora Ave.

Hidalgo, Tx 78557

RFP PREPARATION COSTS

(21) The Hidalgo I.S.D. shall not be held liable for any costs incurred by any respondent for work performed in the preparation of and production of a RFP or for any work performed prior to execution of contract.

EQUAL EMPLOYMENT OPPORTUNITY

(22) Respondent agrees that they will not discriminate in hiring, promotion, treatment, or other terms and conditions of employment based on race, sex, national origin, age, disability, or in any way violate Title VII of 1964 Civil Rights Act and amendments, except as permitted by said laws.

AUTHORIZATION TO BIND RESPONDENT TO RFP

(23) RFPs MUST give full firm name and address of respondent, and be manually signed. Failure to do so will disqualify your RFP. Person signing bid must show title or AUTHORITY TO BIND HIS/HER FIRM IN A CONTRACT. Firm name and authorized signature must appear on each page that calls for this information.

The legal status of the Respondent whether corporation, partnership, or individual, shall also be stated in the RFP. A corporation shall execute the RFP by its duly authorized officers in accordance with its corporate by-laws and shall also list the state in which it is incorporated. A partnership Respondent shall give full names and addresses of all partners. All partners shall execute the RFP. Partnership and Individual Respondent shall state in the proposal the names and addresses of all persons with a vested interest therein. The place of residence of each Respondent, or the office address in the case of a firm or company, with county and state and telephone number, shall be given after the signature.

Confidential Information Respondents are advised that all confidential records must be submitted in a separate sealed envelope and marked accordingly.

Hidalgo, TX. 78557

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GENERAL

Hidalgo I.S.D. is currently seeking proposals from qualified vendors for Gasoline and Diesel Fuel.

The Transportation Department will be placing orders as needed from the awarded vendor(s) following school board approval.

SCOPE OF SERVICES

The selected vendor will be used to supply Gasoline and Diesel Fuel on an as needed basis. Proposals must clearly identify the brand or trade name of each fuel product offered.

Any fuel additives used must:

• Be approved by the U.S. Environmental Protection Agency (EPA)

• Be compatible with the refiner’s fuel product

• Not increase sulfur emissions or other substances prohibited by EPA Regulations

The vendor shall be fully responsible and liable for all remediation, damages, and costs resulting from the delivery or use of defective, contaminated, or non-compliant fuel.

All qualified SUPPLIERS have current licenses as required under the State of Texas under the Supplier Texas Motor Fuel License and must hold an IRS Form 637 registration.

LICENSES

Each proposer must carefully review all sections and submit their copy of their IRS Form 637 registration certificate and submit your Vendor Fuel Distributor/Supplier License.

DELIVERY OF FUEL

Vendor will be required to deliver fuel free of charge. Vendor will be required to deliver fuel within 24 hours.

PRICING STRUCTURE

Pricing shall be based on weekly Oil Price Information Services (OPIS) rack average prices, plus or minus a fixed markup or discount for the contract term.

• The discount or markup shall remain constant for the duration of the contract

• Invoices must clearly reflect the OPIS base price and the applied adjustment

HISD is exempt from federal and state fuel taxes. All mandatory fees must be listed separately.

Undisclosed fees will not be paid unless imposed after contract award. Vendors will be required to file tax exemption forms on behalf of the district.

CONTRACT TERM

The initial contract term shall be one (1) year, with the option to renew for two (2) additional one-year periods.

Subject to Board approval.

PRICE ADJUSTMENTS

Vendor shall provide a 30-day notice of any price changes during the term of the agreement and provide supporting manufacturers and/or distributor documentation to support such as price adjustments. The price change cannot exceed 10% of the total contract award.

Hidalgo, TX. 78557

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INSURANCE REQUIREMENTS

A. General Liability

The Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or property damage, which may arise from or in connection with the performance of the work hereunder by the Contractor, its agents, representatives, or employees. A failure to obtain and maintain such insurance or to file required certificates and endorsements shall be a material breach of contract.

The Contractor's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Vendor to the coverage provided by such insurance or otherwise limit MISD’s recourse to any remedy available at law or in equity.

For the duration of this contract and any extension hereof, Contractor shall carry in a solvent company authorized to do business in Texas, comprehensive general liability insurance in the following amounts:

• $1,000,000.00 Per Occurrence

• $1,000,000.00 General Aggregate

• $1,000,000.00 Products/Completed Operations-Occurrence & Aggregate

HISD shall be named as an additional insured. Thirty (30) days’ written notice of cancellation or material change is required.

B. Workers’ Compensation

For the duration of this contract and any extension hereof, Contractor shall carry Workers' Compensation and Employers' Liability Insurance in the amount required by Texas law: $500,000.00.

INDEMNIFICATION

To the fullest extent permitted by law, the Contractor shall indemnify, defend, and hold harmless Hidalgo Independent School District (HISD), its Board of Trustees, officers, employees, and agents from and against any and all claims, damages, losses, liens, causes of action, suits, judgments, and expenses, including attorney’s fees and other legal costs, of any nature, kind, or description, to the extent arising out of or resulting from the performance of the Contractor’s work or services under this contract, including but not limited to:

● Injury or death to persons,

● Damage to property,

● Defects in materials or workmanship, or

● Violations of any applicable laws, regulations, or codes, Provided that such claim, damage, loss, or expense is attributable to bodily injury, sickness, disease, or death, or to injury to or destruction of tangible property, and is caused in whole or in part by any negligent act or omission of the Contractor, any subcontractor, anyone directly or indirectly employed by them, or anyone for whose acts they may be liable.

This indemnity obligation shall not be limited by any insurance requirements or by any limitation on the amount or type of damages, compensation, or benefits payable by or for the Contractor under workers’ compensation acts, disability benefit acts, or other employee benefit acts.

Hidalgo, TX. 78557

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SELECTION PROCESS

Respondents must provide all information outlined in the Evaluation Factors to be considered responsive.

Proposals will be evaluated based on the responsiveness of the Respondent’s information to the Evaluation Factors, which will demonstrate the Respondent understands the Evaluation Factors and capacity to perform the required services of this Request for Proposals. Proposals will be evaluated based on the following Evaluation Factors:

a. The Purchase Price 50 Points

b. Filling of Tax Exempt forms 25 Points

c. Delivery Fees 15 Points

d. Submission of Certificates 10 Points

DISTRICT EVALUATION OF PRICING OPTIONS

The District will evaluate all pricing submitted. It will select the option that provides the greatest overall cost savings and the best value to HISD. The District reserves the right to award a single vendor or multiple vendors based on the total evaluated cost and best value determination.

The Hidalgo ISD Board of Trustees reserves the right to accept or reject all or any part of any qualifications, waive minor qualifications formalities and award the qualifications deemed to be most advantageous to the Hidalgo ISD.

Hidalgo I.S.D. currently anticipates conducting the selection process proceeding in accordance with the following list of milestones. This schedule is subject to revision and Hidalgo I.S.D. reserves the right to modify this schedule as necessary, in its sole discretion.

1st Publication RFP July 26, 2026

2nd Publication RFP August 2, 2026

RFP Submission Deadline (Post Marked or Delivered) August 13, 2026 Board of Trustees Selects Firm(s) Next Board Meeting

Responses to the RFP must be addressed to Edward Gonzales, Director of Purchasing, Hidalgo I.S.D., and received at Business Office, at 309 E. Flora Ave., Hidalgo, Texas 78557 by Thursday, August 13, 2026, and no later than 1:00 pm. One (1) complete sets of the response along with a USB and must be submitted no later than this date and time. The RFP is to be placed in a sealed envelope indicating that its contents are in response to the REQUEST FOR PROPOSALS for the “GASOLINE AND DIESEL FUEL”

Hidalgo, TX. 78557

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ATTACHMENT

Cost of Diesel and Gasoline Fuel

Hidalgo, TX. 78557

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REFERENCES

Please provide at least three (3) references that have used your company for the same goods HIDALGO ISD is requesting in this proposal. Please include contact name, business name, address, telephone number, and e-mail address.

Company Name: Contact Name:

Telephone: Email:

Address: Brief Description of Business with Company:

Company Name: Contact Name:

Telephone: Email:

Address: Brief Description of Business with Company:

Company Name: Contact Name:

Telephone: Email:

Address: Brief Description of Business with Company:

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DEVIATION AND COMPLAINCE SIGNATURE FORM

If your company intends to deviate from the General Terms and Conditions, Item Specifications or other requirements associated with this Proposal Invitation, you must list all such deviations on this form and provide complete and detailed information regarding the deviations on this form, an attachment to this form, or elsewhere in your Proposal. (If you do not provide the information on or as an attachment to this form, the information must be clearly identified in your Proposal.) Hidalgo ISD will consider any deviations in its contract award decision and reserves the right to accept or reject a proposal based upon any submitted deviation.

In the absence of any deviation identified and described in accordance with the above, your company must fully comply with the General Terms and Conditions, Item Specifications and all other requirements associated with this Proposal Invitation if awarded a contract under this Proposal Invitation.

No Deviations.

Yes Deviations.

List and fully explain any deviations you are submitting:

PLEASE PROVIDE THE FOLLOWING INFORMATION:

1. Shipping Via: Company Truck Other

2. Payment Terms: Net 30 days

3. Number of Days for Delivery:

4. Vendor Reference/Quote Number:

5. Submit a copy of IRS Form 637 Yes or No

6. Submit a copy of Texas Supplier License Yes No

Company Name:

Signature of Authorized Company Official Printed Name

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FELONY CONVICTION DISCLOSURE

Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of

Contractor) states: “A person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony.”

Section 44.034 further states in Subsection (b): “A school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract.”

Please check (√) one of the following:

My company is a publicly held corporation. (Advance notice requirement does not apply to publicly held corporations.)

My company is not owned or operated by anyone who has been convicted of a felony.

My Company is owned/operated by the following individual(s) who has/have been convicted of a felony: Name of Felon(s):

Details of Conviction(s):

By signature below, I certify that the above information is true, complete, and accurate and that I am authorized by my company to make this certification.

Company Name

DEBARMENT CERTIFICATION

Neither my company nor an owner or principal of my company has been debarred, suspended, or otherwise made ineligible for participation in Federal Assistance programs under Executive Order 12549, “Debarment and Suspension,” as described in the Federal Register and Rules and Regulations.

By signature below, I certify that the above is true, complete, and accurate and that I am authorized by my company to make this certification.

Company Name

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Non-Collusive Bidding Certification:

By submission of this bid or proposal, the Bidder certifies that:

a. This bid or proposal has been independently arrived at without collusion with any other bidder or with any competitor.

b. This bid or proposal has not been knowingly disclosed and will not be knowingly disclosed prior to the opening of bids or proposals for this project to any other bidder, competitor, or potential competitor.

c. No attempt has been or will be made to induce any other person, partnership, or corporation to submit or not to submit a bid or proposal.

d. The person signing this bid or proposal certifies that he/she has fully informed himself/herself regarding the accuracy of the statements contained in this certification, and under the penalties being applicable to the bidder as well as to the person signing in its behalf.

Printed Name:

Authorized Signature:

Company:

Title:

Date:

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CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ

For vendor doing business with local governmental entity

This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.

This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.

OFFICE USE ONLY

Date Received

1 Name of vendor who has a business relationship with local governmental entity.

Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)

3 Name of local government officer about whom the information is being disclosed.

Name of Officer

4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.

Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form

CIQ as necessary.

A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?

Yes No

B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity?

Yes No

5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director or holds an ownership interest of one percent or more.

Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).

Name of signatory Signature Date

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CONFLICT OF INTEREST QUESTIONNAIRE

For vendor doing business with local governmental entity

A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/

Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.

Local Government Code § 176.001(1-a): "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.

Local Government Code § 176.003(a)(2)(A) and (B):

(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:

(2) the vendor:

(A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that

(i) a contract between the local governmental entity and vendor has been executed;

or

(ii) the local governmental entity is considering entering into a contract with the vendor;

(B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that:

(i) a contract between the local governmental entity and vendor has been executed; or

(ii) the local governmental entity is considering entering into a contract with the vendor.

Local Government Code § 176.006(a) and (a-1)

(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and:

(1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);

(2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1); or

(3) has a family relationship with a local government officer of that local governmental entity.

(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of:

(1) the date that the vendor:

(A) begins discussions or negotiations to enter into a contract with the local governmental entity; or

(B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or

(2) the date the vendor becomes aware:

(A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a);

(B) that the vendor has given one or more gifts described by Subsection (a); or

(C) of a family relationship with a local government officer.

http://www.statutes.legis.state.tx.us/