Attachment D Vendor Certification_.pdf
PDF 14 KB Posted
- Attached to
- Career Technical Education Table & Chair RFP
- Solicitation number
- RFP - GIS - 200000002103
- Issued by
- Genesee County, Flint City, Michigan
About this file
This document is a Vendor Certification form from the Genesee Intermediate School District in Flint, Michigan. The form requires bidders to certify that they are not an Iran-linked business as defined by the Iran Economic Sanctions Act, MCL 129.311 et seq. Submission of a false certification may result in contract termination, ineligibility to bid for three years, and civil penalties. The contract opportunity this form is associated with is a Request for Proposals (RFP) for Career Technical Education Tables and Chairs, which will be awarded by the Genesee Intermediate School District and the jurisdictions of Genesee County and Flint City.
The pricing terms, set asides, incumbents, funding requirements, and other salient details are not provided in this document. The form focuses solely on the certification requirement related to the Iran Economic Sanctions Act.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B Bid Form Part I.pdf | ||
| Attachment A Project Description.pdf | ||
| Attachment B Part II.xlsx | XLSX spreadsheet | |
| Instructions to Bidders.pdf | ||
| Attach C Familial Statement_.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 517 OF 2012
IRAN ECONOMIC SANCTIONS ACT CERTIFICATION
I am the Click here to enter text of Click here to enter text, or I am bidding in my individual capacity ("Bidder"), with authority to submit a binding bid for the provision of Click here to enter text. services to Genesee Intermediate School District. I have personal knowledge of the matters described in this Certification, and I am familiar with the Iran Economic Sanctions Act, MCL 129.311, et seq. ("Act"). I am fully aware that the school district will rely on my representations in evaluating bids.
I certify that Bidder is not an Iran-linked business, as that term is defined in the Act. I understand that submission of a false certification may result in contract termination, ineligibility to bid for three (3) years, and a civil penalty of $250,000 or twice the bid amount, whichever is greater, plus related investigation and legal costs.
Any bids that do not include this sworn and notarized Certification 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: ______________________________________________________________
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 D
File details come from the government source that posted it. Updated .