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CONFLICT OF INTEREST QUESTIONNAIRE
<br />For vendor doing business with local governmental entity
<br />A compkie copy of Chapter l 76 of the Local Governrinent Code rinay kpe fourild at Ix Us/
<br />Docs4ii-WhIii MAI 76JOrn. Fm easy refeirence, Wow are soine of Mhe sections Kedcaul It* foirm,
<br />."BusMess Waflonship" means ac1,)ninpdJoiir belweentwoormor epwdes
<br />based oin c,Dri�iiinei,e�a�art��v�tyotonllI &
<br />D theparltes. I he term does not 4iolude a conneatton, based on:
<br />,(A) a trans acfloni 1hal ls subject W iii ate gym,. fee uIegiikfion kr a fedwal, state, oir fecaf gieveinn"ientdI enfity or an
<br />aglaricy cit a federM, state, ar tarW goverilluniental enflttr;
<br />(R) a tisaGI]On conducted at a pose andI to teirns avand!se to the flublic; ct
<br />( a 1XVCf WISID 011l'ten :15M Of gOIDds or servIices fiI a pirnann that ls chailereid by a state or federal agency and
<br />Otat lis sul)jiucl to ropAir examinafion IIby, and reportfrig to, If laq agEmcy.
<br />Local Govii,arritnent Code �§ 1-j!6. Q�t.3
<br />.................. . 1-11 ---. Aa),�2) C4)_!!flf4,(N:
<br />(a) AIlocal,gowpem,iuiriaen�roffi(,en,sll°ianfff,ii:laronflicisflim iostutestafrory,uetilwitliiii,espiectloaveii�'ridon U�
<br />*K.
<br />(2) 1 hevisralor',
<br />(A) has an aInjIlAoyment arntherbusiness relafionsNpwNh the locaf gavernirneritofficer ora
<br />UnRy rine mber of throe officier that misii,Rs in the officer, or lamgy nreml!)eR meceiviiii'lg taxakfle
<br />inconno, oltherthan tirvestment hwaIne, that exceeds $2,500 duilling the 12-rnonth prigd
<br />prece6nq t5e date fltat AI's te olfiq*r bnies aware that
<br />(fl a colinrilact belvies'n the kaIt governmeint al enitty aind vendw has „ seem executed;
<br />or
<br />ffi) 1he loical povefnirnrs,Aa� entily lm considering entering Wo a oontmacl, nm th bm
<br />vendor
<br />(13) has given 1!0 the k)I�li govelinInelill officer Gra faillitly ineW)eropt gre ofificer one or rnare gifills
<br />fhat hwipavii aq
<br />intliel2-iiironthperiodperm ,,cewiliiiiigthiedatoq;ll'ie
<br />officer becornes efare thau
<br />(i) a, contract lmlween the �ocal governmental eii'dityand venidm has bee execruted-, m
<br />lip) the focal governmental eratty is considedng entering into a contrast with the vendur,
<br />Local Goverrenent 11
<br />11111111--.—'--- . . . ..........
<br />(a) AveindoIlssl file acompWated coii,iifiir-totit° ter(astqijeclionrit if theverdin has a busIness i1eladaI
<br />witfi[ a WM goverilvinenial entity and:
<br />(1) has air em1roymend or Urer business r6afionsHtj kh a IUnnnp government officer of that Illocal
<br />()Isamu Uu,lvipn a tI government officer of that lined goverrimein0f m�inffty, or as family mmnber of the
<br />amltlicer, ore ar more gitisikith the am Mimes value, spectlied by Siacfort 176.003(a)(2)(n), exchiding any
<br />,gill desarfbed by Section 176, .OGe3(a®1) � r
<br />(3) has a farvifly lehifiandhip wt1h a locaf govIlrinment officer of that lm caf governmentWi entay,
<br />not la,teiii, than the seventh bus' nvss day afteii the later ot.,
<br />this dalIe that the vendm��
<br />(A,) hog�ns ffiscuWoins or negofiatucns to enter into a coniiiact MVI-� the locW: qrvernmentlsl
<br />enrt'po
<br />(B) W!xrlis to 11're kwdl governmenilaf men fity an appHicaUon, ieqj.,*n%e to a u'equesi for piolrosals
<br />ar Inds, ronesporidence, or airmthei writing rekled to a polenfial r
<br />JoCal
<br />goverrinrental en&y!ol,
<br />(2 1he date thie vendop becorrms awate,
<br />(A) of aina eiiiiiployrnent aii mall nor kwsiness rolafioinsMp vfRh a local glevenism erit officer, ow a
<br />falrlfly MiDrIbOr Of 011ie off bs�rr
<br />, , desaflDed 11':ry Subscedoin (a):1
<br />(B) fl,iiat fhe vendirri has, giveini aw or iniore His described by Subsection (a); or
<br />(G) of a farI retalfonsfll:p wfttn a focail government officer.
<br />ronriprWid,i3d by Tbxas E1110or, Cainmomdun unwellics,63'ale Mus Wofted IM0016
<br />Page, tit of'25
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