Attachment C Familial Statement.pdf
PDF 14 KB Posted
- Attached to
- Summerfield Room Divider RFP
- Solicitation number
- RFP-GIS-250000002508-3
- 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, required under Public Act 232 of 2004. The form mandates that all bidders must submit a sworn and notarized statement disclosing any familial or business relationships between the bidder, the bidder's employees, and any members of the GISD Board of Education, Superintendent, or other district officials. Bids submitted without this completed disclosure statement will not be accepted.
The disclosure form requires potential contractors/vendors/respondents to provide their name, address, contact information, and a detailed statement of any existing business or familial relationships. The document includes spaces for the authorized representative to print their name, title, and provide a signature, as well as a notary section to formally acknowledge the statement. This form serves as a transparency mechanism to prevent potential conflicts of interest in the bidding and contracting process for the Genesee Intermediate School District.
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Other files
| File | Type | Posted |
|---|---|---|
| Iran Economic Sanctions Act Certification.pdf | ||
| Attachment E.pdf | ||
| Acc Attachment A Project Description (005).pdf | ||
| Attachment B Bid Form.pdf | ||
| Attachment B BID FORM Part II.xlsx | XLSX spreadsheet | |
| GISD Summerfield Room Divider RFP 2025 - Addendum_1.pdf | ||
| Instruction to Bidders 2192021.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 .