Attachment C Familial Statement.doc
DOC document 31 KB Posted
- Attached to
- GCI Army JROTC Air Gun Electronic Target System
- Solicitation number
- RFP GIS 180000000052 1
- 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 and respondents to bids issued by the District must submit a sworn and notarized statement disclosing any familial or business relationships existing between the bidder, bidder's employees, and members of the Genesee Intermediate School District Board of Education, the District Superintendent, or any other District official. Bids submitted without this completed and notarized statement will be rejected and not accepted for consideration.
The form requires the bidder to provide company name and address, contact information, and a detailed statement of any business or familial relationships with District personnel. The authorized representative of the contractor, vendor, or respondent must sign and date the statement. A notary public must acknowledge and notarize the instrument, including the notary's signature, commission expiration date, the county where acknowledgment occurred, and the date of notarization with an official seal affixed.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| JROTC electronic target Bid request Attachment B.pdf | ||
| JROTC Electronic Target Bid request.pdf | ||
| JROTC electronic target Bid request Attachment A.pdf | ||
| Attachment D Vendor Certification.doc | DOC document |
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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
Attachment C
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:
Seal:
File details come from the government source that posted it. Updated .