Attach C Familial Statement_.pdf
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- Solicitation number
- RFP GIS 210000000845 1
- Issued by
- Genesee County, Michigan
About this file
This is a Familial Relationship Disclosure Statement required by the Genesee Intermediate School District located in Flint, Michigan, under Public Act 232 of 2004. The document serves as a mandatory compliance requirement for all bidders and respondents submitting proposals to the District. Bidders must provide a sworn and notarized statement disclosing any familial or business relationships between the bidder's organization, its employees, and members of the Genesee Intermediate School District Board of Education, the Superintendent, or any other District official. Failure to include this completed and notarized statement with a bid submission will result in the bid being rejected and deemed non-responsive.
The document provides a standardized form for contractors, vendors, and respondents to disclose relationship information. Bidders must complete sections identifying their name and address, contact information, and details of any existing business or familial relationships with District personnel. The form requires authorization by a person empowered to bind the contractor and must be executed before a Notary Public with the notary's seal, signature, and commission expiration date included. This disclosure requirement applies uniformly to all bids submitted to the Genesee Intermediate School District and represents a conflict-of-interest mitigation measure mandated by Michigan state law.
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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 .