HomeMy WebLinkAbout2023 01 06 Foreman, Mike - Conflict of Interest Forms (CIS)THE STATE OF TEXAS §
§ AFFIDAVIT OF CONFLICT OF INTEREST
COUNTIES OF GALVE1STONMARRIS §
I, Ih1KE 4o1UM({N , as a member of the Friendswood City Council make this affidavit and hereby, on
oath, state the following:
I, and/or a person or persons related to me in the first degree of consanguinity or affinity, have a
substantial interest in:
the below -described business entity in that an action on the matter will have a special
economic effect on the business entity that is distinguishable from the effect on the public
or
❑ the below -described real property in that it is reasonably foreseeable that an action on the
matter will have a special economic effect on the value of the property distinguishable from
its effect on the public.
The business entity or real property is:
�Kl rjDSWooD RE%RrE2 f��ut)s
Name/Description of real property
Address of business/real property
I, and/or a person or persons related to me in the first degree of consanguinity or affinity, have a
substantial interest in this business entity/real estate for the following reasons:
❑ Ownership of 10% or more of the voting stock or shares of the business entity; or
Ownership of 10% or more of the fair market value of the business entity; or
❑ Ownership of $15,000 or more of the fair market value of the business entity; or
❑ Equitable or legal ownership in real property having a fair market value of $2,500 or
more; or
❑ Receipt of funds from the business entity exceeds 10% of my/my relative's gross income
for the previous year.
(check all that apply).
Upon the filing of this affidavit with the City Secretary, I affirm that I shall abstain from any
discussion, vote, or decision involving the above -referenced business entity or real property and
from any further participation in this matter whatsoever atthe Council meeting held on Jp_ MAQ9 q ,201 s,
1#4 , ` �!(
Signed this day of J#A0.p20z, j ,
Title of Official
mil(,-� 'F�r-ehnan
BEFORE ME, the undersigned authority, this day personally appeared a member of the City
Council of the City of Friendswood, Texas, and on oath stated that the facts hereinabove stated are true and correct
to the best of his/her knowledge or belief. AOYI
Sworn to and subscribed before me on this (Y day of JQ""' 2015
�IM���
RENEE RRO55 �
Notary lD N1120<2519
µy Commission Expires Notary Public in and for the State of Texas
June 6. 2027 My commission expires: J UA&.Q, In I Za23
1ACouncil-MayoAConaicts of Interest FonnU022 FomrsTonaict of Interest -Council - Fomn.docx
LOCAL GOVERNMENT OFFICER CONFLICTS FORM CIS
DISCLOSURE STATEMENT
(Instructions for completing and filing this form are provided on the next page.)
This questionnaire reflects changes made to the law by H.B. 233 84th Leg., Regular Session,
OFFICEUSEONLY
This is the notice to the appropriate local governmental entity that the following local
government officer has become aware of facts that require the officer to file this statement
Date Received
in accordance with Chapter 176, Local Government Code.
J
FV)JOLI...Inlna
, aYL�
1 Name of Local Government Officer
JJ
M11« 6M MOU3
U
2 OfficeHeld
Mayon
3 Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government
Code
�(Lletso6o)00U 96%jeT61Z t�vsS
4 Description of the nature and extent of each employment or other business relationship and each family relationship
with vendor named in item 3.
M sots J tM iFoawAtl, is Tim owrtr< �v I,1 S IkE2
5 List gifts accepted by the local government officer and any family member, If aggregate value of the gifts accepted
from vendor named in item 3 exceeds $100 during the 12•mo''n11th period described by Section 176.003(a)(2)(B).
Date Gift Accepted Description Gift NOIJ6
of
Date Gift Accepted Description of Gift
Date Gift Accepted Description of Gift
(attach additional forms as necessary)
6 SIGNATURE I swear under penally of perjury that the above statement is true and correct. I acknowledge that the disclosure applies
to each family member (as defined by Section 176.001(2), Local Government Code) of this local government officer. I
also acknowledge that this statement covers the 1 nth pgrio r{ scdbed by Section 176.003(a)(2)(B), Local
Government Code. ,- /
r✓
Sign to of coal Government Officer
lease complete elth r option b ow:
(1)Affidavit NotaryaENlDEE Y13204xa0562519
My Commission Expires
wo June 6, 2023
NOTARY ST
n I
1 FYt.(Y an `-'" l/ ahU a
yv
Sworn to and subscribed before me by I" 1 IC'i this the day of
23
20 ,tocertifywhich,witness myhand and seal ofoffiice.
QUO\A� 14AA21 - kW-e Pros S DEPAN C"ru SCCr-e+a.ru
Signature of officer administering oath Printed name of officer administering oath Title A officer administerin ath
(2) Unsworn Declaration
My name is , and my date of birth is
My address is ,
(street) (city) (slate) (zip code) (country)
Executed in County, State of , on the day of , 20
(month) (year)
Signature of Local Government Officer (Declarant)
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8l17/2020
LOCAL GOVERNMENT OFFICER CONFLICTS DISCLOSURE STATEMENT
Section 176.003 of the Local Government Code requires certain local government officers to file this form. A "local
government officer" is defined as a member of the governing body of a local governmental entity; a director, superintendent,
administrator, president, or other person designated as the executive officer of a local governmental entity; or an agent of
a local governmental entity who exercises discretion in the planning, recommending, selecting, or contracting of a vendor.
This form is required to be filed with the records administrator of the local governmental entity not later than 5 p.m. on the
seventh business day after the date on which the officer becomes aware of the facts that require the filing of this statement.
A local government officer commits an offense if the officer knowingly violates Section 176.003, Local Government Code.
An offense under this section is a misdemeanor.
Refer to chapter 176 of the Local Government Code for detailed information regarding the requirement to file this form.
INSTRUCTIONS FOR COMPLETING THIS FORM
The following numbers correspond to the numbered boxes on the otherside.
1.
Name
of Local Government
Officer. Enter the name of
the local government officer tiling this statement
2.
Office
Held. Enter the name
of the office held by the local
government officer filing this statement.
3. Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code. Enter the name of
the vendor described by Section 176.001(7), Local Government Code, if the vendor: a) has an 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), Local Government Code; b) has given to the local government officer or a family member of the officer
one or more gifts as described by Section 176.003(a)(2)(B), Local Government Code; or c) has a family relationship with
the local government officer as defined by Section 176.001(2-a), Local Government Code.
4. Description of the nature and extent of each employment or other business relationship and each family
relationship with vendor named in item 3. Describe the nature and extent of the employment or other business
relationship the vendor has with the local government officer or a family member of the officer as described by Section
176.003(a)(2)(A), Local Government Code, and each family relationship the vendor has with the local government officer
as defined by Section 176.001(2-a), Local Government Code.
5. List gifts accepted, if the aggregate value of the gifts accepted from vendor named In item 3 exceeds $100,
List gifts accepted during the 12-month period (described by Section 176.003(a)(2)(B), Local Government Code) by the
local government officer orfamily member of the officer from the vendor named in item 3 that in the aggregate exceed $100
in value.
6. Signature. Signature of local government officer. Complete this section after you finish the rest of this report. You
have the option to either: (1) take the completed form to a notary public where you will sign above the first line that
says "Signature of Local Government Officer" (an electronic signature is not acceptable) and your signature will be
notarized, or (2) sign above both lines that say "Signature of Local Government Officer (Declarant)" (an electronic
signature is not acceptable), and fill out the unsworn declaration section.
Local Government Code § 176.001(2-a): "Family relationship" means a relationship between a person and another
person within the third degree by consanguinity or the second degree by affinity, as those terms are defined by Subchapter
B, Chapter 573, Government Code,
Local Government Code § 176.003(a)(2)(A):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer orfamily member receiving taxable income,
other than investment income, that exceeds $2,500 during the 12-month period preceding the
date that the officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Form provided by Texas Ethics Commission vrxw.ethics.stale.tx.us Revised 8/17/2020
This form should be completed and forwarded to the City Manager's Office as soon as possible prior to the first date that the item is
expected to be placed on the Friendswood City Council agenda.
Date requested for City Council consideration: January 9, 2023
Date submitted: 11/17/2022
Prepared by: Glenda Faulkner, Executive Secretary
Subject: Consider accepting the Official Newspaper Bid (2022=14) of Wood Land Publishing, Inc., d/b/a
Reporter News, and approving a resolution designating such newspaper as the official newspaper of the
City of Friendswood.
Originating Department: City Secretary
Degree of importance:
SUMMARY /ORIGINATING CAUSE
Section 11.02 "City newspaper" of the City of Friendswood Charter states in part that:
The Council shall, at a minimum, biannually designate a public newspaper of general circulation in the
City as official publication thereof, and to continue as such until another is designated, and shall cause
to be published therein all ordinances, notices and other matters required by this Charter, but the
ordinances of the City, or by the Constitution and/or laws of the State of Texas to be published.
The City published a Notice of Invitation to Bid for the Official City Newspaper (Bid No. 2022-14) on
October 5th and October 12, 2022, and posted said notice on the City's websiteon September 23,
2022. On November 10, 2022, two bids were received and opened at 2:00 p.m. The bid submissions
were reviewed and Wood Land Publishing, Inc., d/b/a Reporter News (the "Vendor"), was the lowest
responsible bidder. As such, this item accepts the Vendor's bid and approves a resolution designating
the Vendor as the Official Newspaper of the City of Friendswood. The vendor's bid submission is
attached to this item for your review and includes the terms, specifications and requirements of this
contract. However, below is the base bid information for this item:
Base
Ad Type
Bid
Approximate
Number of Ads
Price
Exhibit
A-1
Legal Notices
55
$3250
Exhibit
A-2
Legal Notices
20
$640
Exhibit
A-3
Legal Notices
25
$2000
Exhibit
A-4
Display Ads
2
$1200
Discounts for repeat notices/ads
27
$ 0
Total Base Bid
$7360
IMMINENT CONSEQUENCES /BENEFIT TO COMMUNITY