Attach C Familial Statement_.pdf
PDF 13 KB Posted
- Attached to
- Manikin Simulation
- Solicitation number
- RFP GIS 190000001509 3
- Issued by
- Genesee County, Michigan
About this file
This is a Familial Relationship Disclosure Statement form issued by the Genesee Intermediate School District in Flint, Michigan, in compliance with Public Act 232 of 2004. The form serves as a mandatory attestation requirement for all bidders and respondents to District bid opportunities. Bidders must disclose any familial relationships or other business relationships existing between the bidder, its employees, and members of the Genesee Intermediate School District Board of Education, the District Superintendent, or any other District official. The statement must be sworn and notarized, and any bids submitted without this completed and notarized disclosure form shall be deemed non-responsive and rejected.
The form requires bidders to provide contractor or vendor information including company name, address, and contact number, followed by a detailed statement of any business or familial relationships with District personnel. The authorized representative of the bidding entity must sign the form, which must then be notarized by a notary public in the relevant county. The notary must certify the date of acknowledgment and include their signature, commission expiration date, and the county in which they are acting. This disclosure requirement applies uniformly to all bidders responding to Genesee Intermediate School District solicitations.
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Other files
| File | Type | Posted |
|---|---|---|
| Acc Attachment A Project Description_.pdf | ||
| Attach B Bid Form.pdf | ||
| Instruction to Bidders.pdf | ||
| Attachment D Vendor Certification_.pdf |
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Text version
GENESEE INTERMEDIATE SCHOOL DISTRICT
ERWIN L. DAVIS EDUCATION CENTER
2413 WEST MAPLE AVENUE
FLINT, MI 48507-3493
PUBLIC ACT 232 OF 2004
FAMILIAL RELATIONSHIP DISCLOSURE STATEMENT
All bids must be accompanied by a sworn and notarized statement disclosing any familial, or other business relationship existing between the bidder (respondent to this Bid) and all employees of the bidder and any member of the Genesee Intermediate School District Board of Education, the Superintendent of the District and/or any other official of the District. Any bids that do not include this sworn and notarized statement shall not be accepted.
Owner Name & Address:
Genesee Intermediate School District 2413 West Maple Avenue
Flint, MI 48507-3493
Contractor/Vendor/Respondent Information:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Contact Number: ______________________________________________________________
Statement of Business or Familial Relationship:
Person Authorized to Bind the Contractor/Vendor/Respondent:
Print Name Title
Signature Date
Seal:
This instrument was acknowledged before me, a Notary Public, in and for ___________________________ County, _____________________ on this _________ day of ________________________, 20_________.
State
Notary Public Signature Date
My Commission Expires: _______________________
Acting in the County of: ________________________
Attachment C
File details come from the government source that posted it. Updated .