HomeMy WebLinkAbout20250806 Rick Fernandez Conflict of DisclosureOCAL
GOVERNMENT
0 FICEN
CONHLllCuS
CIS
FORM
DISCOSURE
STATEMENT
(Instructions
for
completing
and
filing
this
form
the
are
provided
on
next
page.)
This
questionnaire
reflects
changes
made
to
the
law
by
H.B.
23,
84th
Leg.,
Regular
Session.
OFFICE USE ONLY
This
is
the
to
the
local
following
local
notice
has
become
appropriate
facts
governmental
that
entity
that
the
file
Date
Received
government
officer
aware
of
require
the
officer
to
this
statement
in
Chapter
176,
Local
Government
Code.
accordance
with
1
Name
of
Local
Government
Officer
RFCFREI
Rick
Fernandez
AUG
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2
Office
Held
OF
Pearland
City
Council
Position
6
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3
Name
Code
of
vendor
described
by
Sections
176.001(7)
and
176.003(a),
Local
Government
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Fernandez
Investment
Group
Inc
dba
Cop
Stop
4
Description
the
business
with
vendor
of
named
nature
in
item
and
3.
extent
Rick
of
Fernandez
each
employment
is
51
%
owner
or
other
of
Cop
Stop.
Cop
relationship
Stop
has
a
and
supply
each
contract
family
with
relationship
the
City
of
Pearland
that
exceeds
$2500.00.
This
contract
was
entered
into
prior
to
Rick
Fernandez
being
elected.
5
from
List
gifts
vendor
accepted
named
by
in
the
item
local
3
exceeds
government
$100
during
officer
the
and
12-month
any
family
period
member,
described
if
aggregate
by
Section
value
176.003(a)(2)(B).
of
the
gifts
accepted
Date
Gift
Accepted
Description
of
Gift
Date
Gift
Accepted
Description
of
Gift
Date
Gift
Accepted
Description
of
Gift
(attach
additional
forms
as
necessary)
6
I
SIGNATURE
swear
under
penalty
of
perjury
that
the
above
statement
is
true
and
correct.
I acknowledge
that
the
disclosure
applies
to
also
Government
each
acknowledge
family
Code.
member
that
this
(as
defined
statement
by
covers
Section
the
176.001(2),
12-month
period
Local
Government
described
by
Code)
Section
of
176.003(a)(2)(B),
this
local
government
Local
officer.
I
Please
complete
either
option
Signature
below:
of
Local
Government
Officer
(1)
Sworn
Affidavit
NOTARY
to
and
STAMP/SEAL
subscribed
before
me
by
this
the
day
of
,
20
to
certify
which,
witness
my
hand
and
seal
of
office.
,
Signature
of
officer
administering
oath
Printed
name
of
officer
administering
oath
Title
of officer
administering
oath
OR
(2)
Unsworn
Declaration
Rick
Fernandez
My
name
,s
,and
my
date
of
birth
is
My
address
is
1
Pearland
TX
77581
US
Executed
in
6(
air
NA a--
County,
(street)
State
of 1 P.Aca
3
on
the
0•
(city)
(
1#
state)
(zip
20
code)
Cs
(country)
.
0f
,
.
,.�io
)
,
(year)
Signature
of
Lo99
Governor
t
Officer
(Declarant)
Form provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 8/17/2020
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 other side.
1. Name of Local Government Officer. Enter the name of the local government officer filing 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 or family 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 or family 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
www.ethics.state.tx.us Revised 8/17/2020