Form Ciq PDF Details

In the landscape of local governance and procurement processes, ensuring transparency and accountability is paramount. The Conflict of Interest Questionnaire (CIQ) form serves as a crucial tool in this endeavor, specifically designed for vendors engaging in business with local governmental entities. This document, which underwent significant revisions due to H.B. 23 during the 84th Legislative Regular Session, mandates thorough disclosure of any business relationships that might influence, or appear to influence, decisions and actions within local governments. Specifically, it aims to shed light on potential conflicts of interest by requiring vendors to report employment or business relationships, as well as any gifts provided, to local government officers or their family members. With a stringent deadline for submission following the realization of such a relationship—no later than the seventh business day—this form acts as a safeguard against any unethical practices that could undermine the integrity of public administration. Furthermore, failing to comply with these requirements isn't just frowned upon; it carries legal consequences, emphasizing the seriousness with which the law regards the potential for conflicts of interest in governmental affairs. By laying down a systematic framework for disclosure, the CIQ form reinforces the foundation of trust and integrity upon which the public sector operates, ensuring that the operations of local government remain in the best interests of the communities they serve.

QuestionAnswer
Form NameForm Ciq
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform ciq conflict of interest questionnaire, ciq, conflict of interest questionnaire form ciq, conflict of interest form texas

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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.

OFFICE USE ONLY

 

This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who

 

Date Received

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.

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

2

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

5Describe 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.

6

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).

7

 

Signature of vendor doing business with the governmental entity

 

Date

 

 

 

 

 

 

 

Form provided by Texas Ethics Commission

www.ethics.state.tx.us

 

Revised 11/30/2015

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.

Form provided by Texas Ethics Commission

www.ethics.state.tx.us

Revised 11/30/2015