5-Sworn Statement of Familial Relationship.pdf
PDF 57 KB Posted
- Solicitation number
- 051326
- Issued by
- Kent County, Grand Rapids City, Michigan
About this file
This is a Sworn Statement of Familial Relationship form required by Section 1267 of the Revised School Code (MCL 380.1267) for bidders submitting proposals to Grand Rapids Public Schools (GRPS) in Michigan. The form applies to bids for the Building Envelope and Roof Consulting Services project at the GRPS Nutrition Services Facility located in Kent County, Michigan. Bidders must disclose any familial relationships between the bidder's owners or employees and members of the GRPS Board of Education or Superintendent. The statement requires the bidder to either certify that no familial relationships exist or to provide detailed information identifying the specific relationship, the individuals involved, and their respective roles.
The form must be completed under oath before a notary public or other authorized official, with the notary certifying the date of execution and the expiration date of their commission. This disclosure requirement is a mandatory compliance element for all bidders participating in the qualifications-based selection process for this roof consulting engagement, which encompasses existing conditions assessment, design and specifications development, bidding and procurement support, and construction administration services.
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Text version
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 bid for an improvement to the following described project located in Kent County, Michigan, which is owned by the Grand Rapids Public Schools:
Project Name:
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.
OR
2. That a familial relationship exists between an owner employee of the Bidder who is the _________________________ relationship of _____________________________________ , who is a member of the
Board, the Superintendent.
Deponent _________________________________________
Subscribed and sworn to before me this _____ day of _________________, 20_____
Acting in:
My commission expires: ________________
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