ATSI COIQ 2020CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQFor vendor or other person doing business with local qovernmental
Thisquestionnairereflectschangesmadetothelawb'H'B.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as definedby 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 government entity not later than the 7th business day after thedate the vendor becomes aware of facts that require the statement to be RteO. 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 amisdemeanor.
Name of vendor who has a business relationship with local governmental antit!,:
Athens Technical Specialists, Inc.
check this box if you are filing an update to a previously filed questionnaire.
(Ihe law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business dayafter the date on which you became aware that the originally filed questionnaire was incomplete or inaicurate.)
Name of local government ol'licer about whom the information in this section is being disclosed.
N/A
Name of Officer
Describe each employrnent or other busiuess relationship with the local government officer, or a farnily menrber ofthe officer, as clescritred by Section
176.003(a)(2)(A). Also describe any family relations hip with the local govemment officer. This section, (item 3 including subparts A, B, C & D), must becompleted fot each offrcet with whom the vendor ltas an ernplol,meut or other business relationship as defined by Section 176.0b I ( l -a), Local Goyernment CodeAttach additional pages to this Fornr CIQ as necessary.
A. Is the local govemment officer named il'r this section receiving or likely to receive tarable income, other than investment income. from the vendor.?X ,".Xro
B. Is the vendor receiving ol lik€ly to receive taxable income, other thau investment income, from or at tlre direction of the local govemment officer named in
this se,ction AND the taxable income is not received fronr tlrc local govermnental entity?l-l ,.,|__l*o
C. Is the filer ofthis questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer
or director, or holds an ownership of one percent or nrore?
l-l
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Describe each employrnent or business and family relationship with the local government ottcer named in this section.
X] t r,uru no Conftict of lnterest to disclose.
08t20/20
business with the governmental entity Date