16-12. FAMILIAL RELATIONSHIP DISCLOSURE STATEMENT.docx

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Attached to
Medical and Pharmacy Benefits
Solicitation number
26001
Issued by
Maricopa County, Scottsdale City, Arizona

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This document is a Familial Relationship Disclosure Statement for Scottsdale Unified School District #48's Request for Proposal (RFP #26001) for Medical and Pharmacy Benefits. The RFP requires all bidders to submit a sworn and notarized statement disclosing any potential conflicts of interest between the offeror's owners or employees and members of the Scottsdale Unified School District's Governing Board or employees. The response is due on October 15, 2025, and seeks to evaluate the current health benefit program's structure, cost competitiveness, service capabilities, and potential for increased employee satisfaction.

The disclosure statement mandates that bidders transparently report any familial relationships that could constitute a conflict of interest, with a specific section for detailing connections between the firm's employees and district personnel. The RFP is focused on a comprehensive review of medical and pharmacy benefits, indicating the district is seeking potential improvements or alternative providers for its health insurance programs. The document provides a standard template for vendors to complete, ensuring transparency and ethical considerations in the procurement process.

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2-09. PERFORMANCE EVALUATION SURVEY.docx DOCX document
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Scottsdale Unified School District #48 Familial Relationship Disclosure Statement

Purchasing Department 9313 N. 95th Way Scottsdale, AZ 85258 480-484-6151

RFP #: 26001

PROJECT: MEDICAL AND PHARMACY BENEFITS

Familial Relationship Disclosure Statement

All responses to this solicitation shall be accompanied by a sworn and notarized statement disclosing any familial relationship aka, conflict of interest that exists between the owner or any employee of the offeror and any member of the Governing Board of the Scottsdale Unified School District or any employee of the Scottsdale Unified School District:

The undersigned, the owner or authorized officer of (the “Firm”), pursuant to the familial disclosure requirement provided in the attached solicitation, here by represent and warrant, except as provided below, to their best knowledge that no familial relationships exist between the owner(s) or any employee of the company and any member of the Governing Board of the District, Superintendent of the Scottsdale Unified School District or any employee of Scottsdale Unified School District. If such a relationship exists, please explain:

Employee of Firm
Scottsdale Unified School District Connection
How are they related
____________________________________________________
(Printed Name of Person Authorized to Sign Offer)

(Signature of Person Authorized to Sign Offer)

(Title)

RFP #: 26001 Page 1 of 1 Due: October 15, 2025 image1.png

File details come from the government source that posted it. Updated .