Tri-Tech Forensics Inc COIQ 20201
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CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor or other rson doin business with local rnmental
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 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 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.
Name of vendor who has a business relationship with local governmental entity.
Tri-Tech Forensics lnc
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.)
Name of local government officer atrout whom the information in this section is being disclosed.
N/A
Name of Officer
Describe each employment or other business relationship with the local govemment officer, or a family member of the officer, as described 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 be
completed for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.001(l-a), Local Government Code.
Attach additional pages to this Form CIQ as necessary.
A. Is the local govemment olliccr named in this section rcceiving or likely to receive taxablc incomc, other than investment income. fiom the vendor?
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B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the 1ocal govemment officer named in
this section AND the taxable income is not received from the local governmental entity?
Yes I-X I r.ro
or director, or holds an owuership o1'one percent or more?
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D. Describe each employment or business and t'amily relationship rvith the local government officer named in this section.
None
I have no Conflict of lnterest to disclose.
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Signature of vendor doing business with the govemmental entity
11124t2020
Date