1-Sworn statement of Familial Relationship.pdf

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Attached to
Auditorium Lighting Equipment 2026
Solicitation number
AuditoriumLightingEquipment2026
Issued by
Kent County, Grand Rapids City, Michigan

About this file

This is a Sworn Statement of Familial Relationship form required by the Grand Rapids Public Schools District in accordance with Section 1267 of the Revised School Code (MCL 380.1267) in Michigan. The form serves as a disclosure document that bidders submitting proposals to the Grand Rapids Public School District must complete and have notarized. The statement requires the deponent to disclose whether any familial relationships exist between the bidder's owners or employees and members of the Grand Rapids Public Schools Board of Education or the Superintendent.

The form provides two disclosure options: the first allows bidders to certify that no familial relationships exist, while the second requires detailed identification of any such relationships, including the names of the related parties, their roles, and the nature of the familial connection. The completed and sworn statement must be notarized by a Michigan notary public and includes spaces for the notary's commission expiration date. This disclosure requirement is intended to ensure transparency and prevent conflicts of interest in the procurement process for the school district.

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Grand Rapids Public Schools

Grand Rapids Public Schools SWORN STATEMENT OF FAMILIAL RELATIONSHIP

FORM OF SWORN STATEMENT OF FAMILIAL RELATIONSHIP

As required by Section 1267 of the Revised School Code – MCL 380.1267

STATE OF MICHIGAN

COUNTY OF __________________

_________________________________________, being duly sworn, deposes and says:

That _______________________________________ (The “Bidder”) has submitted a proposal for the Grand Rapids Public School District.

That the following is a statement of disclosure of any familial relationship that exists between the owner or any employee of the Bidder and any member of the Grand Rapids Public Schools

Board of Education or Superintendent, as required pursuant to Section 1267 of the Revised

School Code, as amended.

1. That there are no such familial relationships existing at this time.

2. That a familial relationship exists between _____________________________, who is an (owner) (employee) of the Bidder and the _________________________________

(nature of familial relationship I.e. brother, sister, cousin, etc.)

of ___________________________________who is _____________________________

(a member of the Board), (the Superintendent).

Deponent

Subscribed and sworn to before me this _________________Date of __________,2016

Notary Public of MI, County of

Acting in:

My commission expires:___________________

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