HomeMy WebLinkAboutC. Green Scaping, LP 2023CONFLICT OF INTEREST QUESTIONNAIRE, FORM CIO
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 841h Log., Regular Session. OFFICEUSEONLY
Ibis questiorinWie is being filed in acocirdance with Chapter 176, Local Goveniment Code, by a vendor who Vato Received
has a business relationship as d8figied by Section 176 001(1-ay will) a local governmental enWy and the
vendor meets requirements under Sacbai, 1760�06(a)
By law ails questionnaire must be filed widi die iecords administrator of the local governmental entry rim later
Man die 7fli ixisiness day after the date the vendor becornes aware of fact,; treat requVe the staternem to be
Wed. Sere Section 176 006(a-lI, Locat Government Code,
A vendor commits an ON, rise if the vendoi knoMiq�y violare, Soriioiri 176 006, Local Government Code. Ail
offenee under this section O� a rnisdomeanoi
jJ Name of vertdor who has a business relationship with local governmental entity.
C. Green Soaping, LP
21 Check this box it you are filing an update to a previously filed questionnaire. (The lawn requires that you ffle an updated
NEI
completed queslionnaite with the appropriate Jiling authority not later than the 7th business day after the date on which
you became aware that the originally flied questionnaire was incomplete or inaccurate
Name of local government officer about whorrithe information Is being disclosed.
N/A
. . ............. .
Name of Officer
IJ Describe sach 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 relationship with the local'! government officer.
Complete subparts A and Slot, each employment or business relationship described, Attach additional pages to this Form
CIO as necessary.
A is the local government officer or a farnily member of the officer receiving or likeiy to receive taxable income,
other than investment income, from the vendor?
Yes rU9 No
1.06�
S. Is the vendor receiving or likely to receive taxable income, other than investment income, from of at the direction
of the local government officer or a family member of the officer AND the taxable Income is not received from the
local governmental entity?
F-1 Yes IX No
IJ Describe each employment or business relationship that the vendor named inSection I maintains wilha corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
NIA
.Pi Check this box it the vendor has given the local government officer or a lartilly member of the officer one or more gifts
as described in Section 176,003(a)(2)(9), excluding gills descriloed in Section 176.003(a-1)
7
1124/23
Sign irrr of vendor ddIK65uvriess with the governmental entity Date
Form provided by Texas Ethics Commission WWW ethics Stare,AXAAS Revised 11130/2015
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