Disclosure Statements

Required Disclosure Statement - for Local Government Officers

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 Nacogdoches Memorial Health 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.

The Questionnaire is available for viewing and downloading in PDF from the Texas Ethics Commission: Form CIS Conflict of Interest Form and Instructions.

House Bill 914 

Required Disclosure Statement - for Vendors doing business with local government entity

Effective January 1, 2006, Chapter 176 of the Local Government Code requires that those who contract with or seek to contract with the Nacogdoches Memorial Health whether they are successful or not, for the sale or purchase of property, goods, or individual or business in their dealings with Nacogdoches Memorial Health must file a “Conflict of Interest Questionnaire” with Nacogdoches Memorial Health. 

The Questionnaire requires disclosure of certain business and gift giving relationships, if any, the individuals or businesses may have with local government officers as that term is defined under the new law. This form is to be filed no later than the seventh (7th) business day after the date that the individual or business (or agent) begins contract discussions or negotiations with the local governmental entity; or submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential agreement with the local governmental entity. See, Section 176.006, Local Government Code. 

The vendor is required to update the form no later than the seventh (7th) business day after the date of an event that would make a statement in the previously filed questionnaire incomplete or inaccurate. Also, if the vendor files the initial questionnaire prior to June 1, the vendor must file an updated questionnaire not later than September 1 of each year the vendor has an agreement, contract or potential agreement or contract pending. See, Section 176.006(d), Local Government Code. A person commits an offense if the person violates Section 176.006; an offense under this Section is a Class C misdemeanor.

The Questionnaire is available for viewing and downloading in PDF from the Texas Ethics Commission: Form CIQ: Conflict of Interest Form and Instructions.

Compliance is the responsibility of each individual, business and agent who is subject to the requirements of Chapter 176, Local Government Code. Should you have questions concerning this matter, please consult your own legal counsel. 

Should you determine that you are required to file a Conflict of Interest Questionnaire, please file it electronically by sending it by e-mail to Nacogdoches Memorial Health. A statement filed electronically satisfies the signature requirement and does not need to be notarized.

Businesses that contract with or seek to contract with the Nacogdoches Memorial Health, whether they are successful or not, for the sale or purchase of property, goods, or individuals or businesses in their dealings with the Nacogdoches Memorial Health must file a Conflict of Interest Questionnaire with Nacogdoches Memorial Health. To view PDFs of the Conflict of Interest Questionnaires filed with the Nacogdoches Memorial Health click here. (coming soon)

Certificate of Interested Parties (Form 1295)

In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the Government Code. The law states that a governmental entity or state agency may not enter into certain contracts with a business entity unless the business entity submits a disclosure of interested parties to the governmental entity or state agency at the time the business entity submits the signed contract to the governmental entity or state agency. The law applies only to a contract of a governmental entity or state agency that either (1) requires an action or vote by the governing body of the entity or agency before the contract may be signed or (2) has a value of at least $1 million. The disclosure requirement applies to a contract entered into on or after January 1, 2016.

Form 1295 should be completed electronically. Click here to complete the form. For more information on this form, contact the Texas Ethics Commission. 

 

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