According to Local Government Code, Chapter 176, a person or an agent of a person who contracts or seeks to contract for the sale or purchase of property, goods, or services with Anthony Independent School District must file a completed Conflict of Interest Questionnaire with the Finance Department no later than the seventh business day after the date that the person begins contract discussions or negotiations with the District or submits to the District an application, response to a request for proposals or bids, correspondence, or another writing related to a potential agreement with the District.

This Conflict of Interest Questionnaire must be filed annually by September 1 as long as the person or the agent of the person continues to contract or seek to contract for the sale or purchase of property, goods, or services with the District or not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate. The completion of the Conflict of Interest Questionnaire is not needed if the person is an employee of a governmental entity and is acting in the employee’s official capacity.

Explanation of the Conflict of Interest Questionnaire
Name of person doing business with the District.
Check the box if you are filing an update to a previously filed questionnaire.
Describe each affiliation or business relationship with an employee or contractor of the District who makes recommendations to a District officer with respect to expenditure of funds. If no affiliation or business relationship exists, state “NONE.”

Examples:
If your spouse, parent, or child is the District’s Director of Purchasing and a bid is being submitted to the Purchasing Department, this relationship must be reported. If your spouse, parent, or child is the Principal at a School and your business may sell items directly to that school, this relationship must be reported. If you or your spouse, parent, or child is in business with a District employee that would be making a recommendation concerning a purchase or sales transaction involving you, the relationship must be reported. If you employ or do business with a spouse, parent, or child of a District employee that would be making a recommendation concerning a purchase or sales transaction involving you, the relationship must be reported. If you are a District employee and would be making a recommendation concerning a purchase or sales transaction involving you, the relationship must be reported. If your spouse, parent, or child is a teacher that does not make recommendations concerning purchasing or sales transactions, this relationship should not be reported.

If your spouse, parent, or child is a Principal at a School and a bid is being considered by a separate department such as Facilities Planning (Construction Department), this relationship should not be reported.

Describe each affiliation or business relationship with a person who is a District officer and who appoints or employs a District officer that is the subject of this questionnaire. If no affiliation or business relationship exists, state “NONE.”

Example:
If you or your spouse, parent, or child is related to, employs, or is in business with a District officer or their spouse, parent, or child, this relationship must be reported.

Name of District officer with whom you have an affiliation or business relationship.

For each person listed under question #4, complete page 2. If your answers to A, B, and C are NO, indicate the name of the District officer, but do not complete section D.

Describe any other affiliation or business relationship that might cause a conflict of interest.

Example:
If your neighbor or friend is a District employee that would be making a recommendation concerning a purchase or sales transaction involving you and you feel that your relationship with this employee could affect their recommendation, this relationship must be reported. If any other situation exists that would result in a conflict of interest, the relationship must be reported.

Sign and date this form.

Turn in the completed form to:

Anthony Independent School District
Attention: Accounts Payable Specialist, Toya Deleon
840 Sixth Street
Anthony Texas 79821

If you have any questions, please contact the Fred Herrera, Finance Director at 915-886-6502.