Attachment C Familial Statement.pdf
PDF 14 KB Posted
- Attached to
- Summerfield Room Divider RFP
- Solicitation number
- RFP-GIS-250000002508-2
- Issued by
- Genesee County, Michigan
About this file
This document is a Familial Relationship Disclosure Statement for the Genesee Intermediate School District (GISD), located in Flint, Michigan, as mandated by Public Act 232 of 2004. The form requires bidders to provide a sworn and notarized statement disclosing any familial or business relationships between the bidder, their employees, and GISD board members, superintendent, or other district officials. Bids submitted without this completed disclosure statement will not be accepted.
The disclosure statement is a standard form that must be filled out by potential contractors, vendors, or respondents, requiring them to provide their company information, contact details, and a detailed explanation of any existing relationships with GISD personnel. The document includes spaces for the bidder's name, address, contact information, and a section to describe any familial or business connections. The form must be signed by an authorized representative and notarized, with the notary public providing their county, state, and commission expiration details.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Acc Attachment A Project Description (005).pdf | ||
| Attachment B BID FORM Part II.xlsx | XLSX spreadsheet | |
| Instruction to Bidders 2192021.pdf | ||
| Attachment B Bid Form.pdf | ||
| Attachment E.pdf | ||
| Iran Economic Sanctions Act Certification.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .