00 4100 - Familial Disclosure Statement.pdf

PDF 97 KB Posted

Attached to
Renovation RFP
Solicitation number
RFP - SAN - 240000000552
Issued by
Sanilac County, Sault Ste. Marie City, Michigan

About this file

This document is a Familial Disclosure Statement required for a Renovation RFP issued by Sanilac County and the City of Sault Ste. Marie in the state of Michigan. The RFP requires all bidders to disclose any familial relationships between the bidder's employees and the school district's board members, administrators, or directors. Bidders must complete and include the sworn and notarized disclosure statement with their bid submission. The school district shall not accept any bids that do not include this required disclosure.

The pricing terms, funding requirements, and other contractual details are not provided in this document. The RFP appears to be for a renovation project, but the specific scope of work, quantities, response deadlines, and contract duration are not included in this Familial Disclosure Statement.

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Text version

SECTION 00 4100

FAMILIAL DISCLOSURE STATEMENT

All bidders must complete the following familial disclosure form in compliance with MCL 380.1267 (Public Act 232 of 2004) and attach this information to the bid.

By the attached sworn and notarized statement we are disclosing the following familial relationship(s) that exists between the owner or any employee of the bidder and any member of the board, intermediate school board, or board of directors or the superintendent of the school district, intermediate superintendent of the intermediate school district, or chief executive officer of the public school academy.

The Owner shall not accept a bid that does not include this sworn and notarized disclosure statement.

Disclose any familial relationship and complete the form below in its entirety:

The following are familial relationships as described above (provide employee name, family contact name, family contact position, and familial relationship or NONE.)

Signature(s): Title: Title:

Name of firm:

STATE OF MICHIGAN )

) SS

COUNTY OF )

On this day of , 20 , before me a Notary Public in and for said county, personally appeared , agent of the said firm and who acknowledged the same to be his free act and deed as such agent.

Notary Public

END OF SECTION 00 4100

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