HomeMy WebLinkAboutRivistas LLC CIQ 09.24.26CONFLICT OF INTEREST QUESTIONNAIRE
n_dqlng business with local governmental entity
FORM CIQ
For vendor or other perso
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapler 176, Local Governmenl Code. by a vendor who has a business relationship as defined
by Section 176.001(1-a) with a local govemmental entig 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 lhe records administrator of the local government entity not later than the 7th business day afler the
date the vendor becomes aware of facts that reguire the statement to be filed. See Section 176.006(a-1), Loeal Governmenl 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.
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Check this box lf you are filing an update to a previously filed questionnaire,
(The law requires that you file an updated completed questionnaire with the appropriate flling 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.)
Namc of local Bove romcnl o{Iiccr about whom thc informalion in this scction is bcing tlisclosed.
Name of Officer
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5
Name ofvendorwho has a business re with local govarnmental entity.
Il
l)cscribe cach cmploymcnt or othcr husincss rclationship rvith thc local govcmnrcnt ofliccr. or a I'arnily mcrnbcr of thc ofliccr. a-s dcscrilrccl hy Scction
Attach additional pages to this l"orm CllQ as neccssary.
Ycs
this scction AND thc tiuablc incornc is not rcccivcd lionr thc krcul govcnrnrcntal entity?
Yes
or director. or holds an owrrcrship ofonc pcrccnt or nrorc?
Ycs No
l). Dcscrihc each cnrploynrcnt or bu$incss and linrill' relationship rvith thc local guvcrnnrcnt olficcr nanrctl in this scctirxt.
W I have no Conflict of lnterett to dlsclose.
No
No
Signaturc vcndrlr busincss rvith thc govcrnmcntal cntit5'
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I
x