Attachment C Familial Statement.pdf
PDF 13 KB Posted
- Attached to
- EKLC Teacher Desks RFP
- Solicitation number
- RFP GIS 210000002736 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, pursuant to Public Act 232 of 2004. The document serves as a mandatory sworn and notarized certification that must accompany all bids submitted to the District. Bidders are required to disclose any familial or other business relationships existing between the bidder, all employees of the bidder, and any member of the Genesee Intermediate School District Board of Education, the Superintendent, or any other official of the District. Any bids submitted without this completed and notarized statement will not be accepted by the District.
The disclosure statement requires the bidder to provide their name, address, and contact number, followed by a detailed statement of any business or familial relationships. The form must be signed by a person authorized to bind the contractor or vendor and must be notarized by a Notary Public, who must certify the county and date of acknowledgment as well as the expiration date of their commission. This requirement ensures transparency and compliance with Michigan state law regarding potential conflicts of interest in public procurement processes.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment D Vendor Certification.pdf | ||
| Attachment B Part II 10.12.2021.xlsx | XLSX spreadsheet | |
| Attachment B Bid Form Part I.pdf | ||
| Attachment E School Safety Affidavit.pdf | ||
| Instruction to Bidders.pdf | ||
| Attachment A Project Description.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 .