HomeMy WebLinkAboutCGC General Contractors, Inc. 2024CONFLICT OF INTEREST OUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
ThIls quostionnairo rolWcrs chingas nrl to, the Mw by H,B, 23, 84th Log,, Pegijjtrr Sossion, �FFICE U$F ONLY
Ns p'lasHrminalfe i, p ayrr g, I'lled ln 7, ,Ical Gioverornent Codo t , , ,
6 [, �,/ n 'Vander Whc
bmineis relal ers defli led isy eare,aor 176� (.io j( wltfj a 1,.Caj 5rvairarrwaa�rtel 11, 0,, 'I'd
vendor neels urjrcj(,,j �) a d 0
8y law this que0onrolre rn,lgj &, ljjerj Anjq) fjj,,j 0(ildjjjl 0 the local 9c)voriimenw eqiTy not Wei
Wan The 7�i o-mrliriess dny of* 69 JMe MW Ywrfloi bocomer, awar , a o brxAs i9a,11 raqw r0 Nld f tra
IflINJ 5910 Scklj'� 176 006(a, 1,, 1.ocal Gc,vmr1nlw1t (,ojde
A vend,,,y commur, iri qt Njse it d19 oAldw kilommpy 001MOS 80c6on '176 00C, G.ocal (lovernmi'vit Cxde An
offmmse wnder rhk vcrioji is a rnjulanle,lllrj
J Norhoof vendor who has a buslires:s relationship with focal go ern,
V me. rual enfif
CGC General Contractors, Inc.
Check this box it you are filing an update to a iWeviou sly filed questionnaire, (The law l eqU res I rlw YOU fi le all Updated
(,()rI1PkM0d ques'llornsro wi,li jjitj zJ)proll Ming arjljthoply n0T Wtar Wiari, the 701 busillesrm day RQer flie cjaje rah? VVI,licilI
YOU b0c,,rtille aware that CPr¢r Qr!941ally irred queslloiiraii,e was incom[,)jujo 0� lrjaccufate
m0 Of local government officer 4b*trt WhOu'l the information is, being disclosed,
N/A
Nafne d C,) fficer
Describe each employmell Or, ofilor business ir-ehullonall with the local government officer, <g a family ruernber of the
officer, as described! by Section 1745DO3(a)(2)(A), Also describe any famfly relationship will, the jocal govemment officer,
Cornplote subparts A and 8 for each ernpi oymont or business relall onship desct I bed, Attach, additional pages to this Form
C110 as; necessery,
A Is the to cal goveiriojeil! offic,cr Vas faMilY Il"ICIIIII)w of Pie officer receiving or llk6y Jo rec,aaajve ta,Kable rICcItIre,
ocher than lfivostrrieiq ll"jcr
,grne froo,i Ole V(,jnd0lI?
ED ye, s [K] N'o
B ' s the vendor tece!Oq nr hkely M req-,*ive taxable qicorne Vher tharl twemlne(jj rncovr�e frCCrvt Or M Ifle d4ecliari
Of 010 lacall governll r)JficOr W 81 fafrWY ,Y10,1X16RIr of I'll orticeI AND Ire teaar aEe a,,jc� Onle iS MCA received fl'011 010
k)cN qovemnieritm eMily?
soon e so ch am IA o ym e ri 10 ,, bu of 11 ess rol a 0 onals 4) that t li o vend or it inmed I n S e c if on I ma i ntai n a w i th a corpo rati on o t
diner business entity With oespect to Which the local government officer serves as an officer,
ownership interest of erne Mr oenj or more.
Or directoa, or holds an
ED(--'lleck e I, is Lox it the vew w has give II the local govem I nt�aIV officen or a f a rilly JTIVMbLr of fh(,
as descrlbed in Serilorr 176 003(W(2 iU; excludIng gifts desclibed lrI Seolori 176 003(a-
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02/22/2024
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