Attach C Familial Statement_.pdf
PDF 13 KB Posted
- Attached to
- Crane & Heavy Equipment Operator Simulator
- Solicitation number
- RFP GIS 210000000111 3
- Issued by
- Genesee County, Michigan
About this file
This is a Familial Relationship Disclosure Statement form required by the Genesee Intermediate School District in Flint, Michigan, pursuant to Public Act 232 of 2004. All bidders responding to solicitations from the District must submit a sworn and notarized statement disclosing any familial or business relationships between the bidder, its employees, and members of the District's Board of Education, the Superintendent, or other District officials. Bids that do not include this completed and notarized statement will not be accepted.
The form requires bidders to provide their name, address, and contact information, describe any business or familial relationships with District officials or employees, and include the signature and title of the person authorized to bind the contractor or vendor. A notary public must acknowledge the statement and affix their signature, date, and expiration date of their commission on the document.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment D Vendor Certification_.pdf | ||
| Attachment B Part I.pdf | ||
| Attachment B Part II Bid Form.pdf | ||
| Attachment B BID FORM Part III.xlsx | XLSX spreadsheet | |
| Acc Attachment A Project Description.pdf | ||
| Addendum No. 1.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 .