Model 1 Commercial Vehicles Inc fka Creative Bus Sales Inc CIQ 7.13.23
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person 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) and by City of Denton
Ethics Code, Ordinance 18-757.
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.
1 Name 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 in this section is being disclosed.
Name of Officer
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 relations hip with the local government 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 176.00 1(1-a), Local Government Code.
Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer named in this section 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 named in
this section AND the taxable income is not received from the local governmental entity?
Yes No
C. Is the filer of this 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 more?
Yes No
D. Describe each employment or business and family relationship with the local government officer named in this section.
4
I have no Conflict of Interest to disclose.
5
Signature of vendor doing business with the governmental entity Date
12/13/2023
Attachment to Form W‐9, Request for Taxpayer Identification Number
and Certification
MODEL 1 COMMERCIAL VEHICLES, INC. (fka) CREATIVE BUS SALES INC.
The Federal Employer Identification Number (FEIN) for MODEL 1 COMMERCIAL VEHICLES, INC. (FKA
CREATIVE BUS SALES INC.) is 33‐0388707. As explained in greater detail below, Creative Bus Sales
Inc. is currently in the process of changing its name to MODEL 1 COMMERCIAL VEHICLES, INC.
On June 30, 2023, Creative Bus Sales Inc. filed with the IRS to change the name of the business to
Model 1 Commercial Vehicles, Inc. As of the providing of this W‐9 form, Model 1 Commercial
Vehicles, Inc. has not received confirmation from the IRS of this name change within the IRS system.
Additionally, Model 1 Commercial Vehicles, Inc. has changed their address to 9225 Priority Way
West Drive, Suite 300, Indianapolis, IN 46240, which appears on the W‐9 form. The appropriate
paperwork has been filed with the IRS and Model 1 Commercial Vehicles, Inc. is waiting on
confirmation from the IRS regarding this change in their system.