CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity

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Phyllis O’Connor’
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1 CONFLCT OF NTEREST QUESTONNARE This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offense if the person violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. Name of person doing business with local governmental entity. Global Times nc. & 4b Technology Group o 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 September 1 of the year for which an activity described in Section (a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. Not Applicable Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local governmental entity that is the subject of this questionnaire. Not Applicable FORM cia OFFCE USE ONLY,--., Date Receive~..,,~ c:::::> -~ c:::::> C1r"l..D ftl(/) "'T1 0-1 ft'l OJ..."l>p -,::0 ttl N r -,<J r> -0' -' in' t! ~~~ }> Fgl:i C1(/) 0-< S(J) ~ - ::;......D 1,::: 12f-u ! Amended Amended RFP# Consulting Services for nformation Technology Standards & New Construction Page lof2

2 5 CONFLCT OF NTEREST QUESTONNARE D Yes X No FORM CQ Page 2 Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, B, or C is YES.) This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or business relationship Attach additional pages to this Form CQ as necessary A. s the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? B. s the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? DYes X No C s the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? DYes X No D. Describe each affiliation or business relationship. NA 6 Describe any other affiliation or business relationship that might cause a conflict of interest. None 7 ~)cbaj T)mt?:5 -;j 4-b '~cano/~j ~rc)up PJ~ ()q -50{

3 1 2 CONFLCT OF NTEREST QUESTONNARE This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Govemment Code. A person commits an offense if the person violates Section , Local Govemment Code. An offense under this section is a Class C misdemeanor. Name of person doing business with local governmental entity. o Check this box if you are filing an update to a previously filed questionnaire. FORM CQ OFFCE USE ONLY (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which an activity described in Section (a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. 4 Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local governmental entity that is the subject of this questionnaire. Amended 01/ Amended RFP#09-50l Consulting Services fur nfonnation Technology Standards & New Construction Page 1 of2

4 CONFLCT OF NTEREST QUESTONNARE FORM CQ Page 2 5 Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, S, or C is YES.) This section, item 5 including subparts A, S, C & D, must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional pages to this Form CQ as necessary. A. s the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? D Ves ~. B. s the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? Dves C. s the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? DVes D. Describe each affiliation or business relationship. 6 Describe any other affiliation or business relationship that might cause a conflict of interest. 7 Signature of personf;~~~1if. governmental entity Date v /' RFP# Consulting Services for nformation Technology Standards & New Construction Page 2 of2

5 CONFLCT OF NTEREST QUESTONNARE This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offense if the person violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. 1 Name of person doing business with local governmental entity. 2 Not Applicable to TechKnowledge o Check this box if you are filing an update to a previously filed questionnaire. FORM CQ OFFCE USE ONLY Date Received... "T:z: c=> oftl (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the yearfor which an activity described in Section (a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) c=>...j::>...,... 0 '"T1,...,.,,> OJ N r"t'ul 0'-; ;;u ;:0 ::?<Jrrl ~;oo i-'~ -' :-;;1'< j,.ftlftl» r~o ("")CJ) < c.cj) N ~-;,n ftlr:! (~ 3 Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money. Not Applicable to TechKnowledge 4 Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local governmental entity that is the subject of this questionnaire. Not Applicable to TechKnowledge ~ Amended 01/13/2006 Amended 01/ RFP# Consulting Services for lnfonnalion Technology Standards & New Construction

6 CONFLCT OF NTEREST QUESTONNARE FORM CQ Page 2 5 Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, B, or C is YES.) This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional pages to this Form CQ as necessary. A. s the local govemment officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? DYes D No Not Applicable to TechKnowledge B. s the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? DYes D No Not Applicable to TechKnowledge C. s the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? DYes D No Not Applicable to TechKnowledge D. Describe each affiliation or business relationship. 6 Describe any other affiliation or business relationship that might cause a conflict of interest. 7 Not Applicable to TechKnowledge f&ignature of petsef(9ding business with the governmental entity Date RFP# Consulting Services for nformation Technology Standards & New Constmction

7 CONFLCT OF NTEREST QUESTONNA RE FORM CQ 2 This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offense if the person violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. Name of person doing business with local governmental entity. DougWeis OFFCE USE ONLY Date Received.. tv cr? Check this box if you are filing an updat e to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which an activity described in Section (a), Local Government Code, is pending and not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate,) 3 Describe each affiliation or business relationship with an em pi oyee or contractor of the local governmental entity who makes recommendations to a local government 0 fficer of the local governmental entity with respect to expenditure of money. N/A, 4 Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local governmental entity that is the subject of this question naire. N/A ~/e()derson Amended 01/13/2006 Amended 01/ Page 16 of24 RFP# Consulting Services for nfol111ation Technology Standards & New Construction 2

8 ) ~ CONFLCT OF NTEREST QUESTONNA RE FORM CQ Page 2 5 Name of local government officer with whom tiler has a ffiliation or business relations hip. (Complete this section only if the answer to A. S, or C is YES.) This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional pages to this Form CQ as necessary. A. s the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? Yes No ~ B. s the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? Yes No J C. s the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each affiliation or business relationship. 6 Describe any other affiliation or business rela tionship that might cause a conflict of interest. "J 7 Signature"'m per doing business with the govemmental entity Date November ~ J 09-5{)/ RFP# Consulting Services for nformation Technology Standards & New Construction Page 17 of24 3

Name of local government officer about whom the information in this section is being disclosed. Name of Officer

Name of local government officer about whom the information in this section is being disclosed. Name of Officer CONFLCT OF NTEREST QUESTONNARE For vendor 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