Aerowave Technologies LLC CIQ 1.30.24CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made
This questionnaire Is being filed in accordance
by Section 176.001(1-a) with a local
By law this questionnaire must be filed with the
date the vendor becomes aware of facts
A vendor commits an offense if the vendor
misdemeanor.
to the law by H.B. 23, 84th Leg., Regular Session.
with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined
governmental entity and the vendor meets requirements under Section 176.006(a).
records administrator of the local government entity not later than the 7th business day after the
that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
knowingly violates Section 176.006, Local Government Code. An offense under this section is a
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Name of vendor who has a business relationship with local governmental entity.
ArentifnViltre er-CCIAIA'
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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.)
II Name of local government officer about whom the information in this section Is being disclosed.
4-E Ar
Name of Officer
Describe
176.003(a)(2)(A).
completed
Attach
each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section
Also describe any family relations hip with the local government officer. This section, (item 3 including subparts A, B, C & D), must be
for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.001(I-a), Local Government Code.
additional pages to this Form CIQ as necessary.
Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the vendor? •
Yes In No
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?
fl Yes "(No
.
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 Nit No
Describe each employment or business and family relationship with the local government officer named in this section.
4 IP I have no Conflict of Interest to disclose.
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ettal.0.: kin itZks__, COYANorAO-r
Signature of vendor doing business with he governmental entity Date