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Burns Controls Co CIQ 04.29.2025CONFLICT 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 definedby Section 176.001(1-a)with a local governmental entity and the vendor meets requirements under Section 176.006(a)and by City of DentonEthics 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 thedate 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 amisdemeanor. 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 dayafterthedateonwhichyoubecameawarethattheoriginallyfiledquestionnairewasincompleteorinaccurate.) 3  Name of Officer              I have no Conflict of Interest to disclose.                                                          Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015