Attachment D Vendor Certification_.pdf
PDF 14 KB Posted
- Attached to
- Manikin Simulation
- Solicitation number
- RFP GIS 190000001509 3
- Issued by
- Genesee County, Michigan
About this file
This is a vendor certification document issued by Genesee Intermediate School District located in Flint, Michigan, required for bidders seeking to provide unspecified services to the district. The certification form requires bidders to provide their company name, address, contact information, and identify the authorized representative with binding authority. Bidders must submit this notarized certification as part of their bid package; bids without the completed and sworn certification will not be accepted.
The document enforces compliance with Michigan's Public Act 517 of 2012, the Iran Economic Sanctions Act (MCL 129.311 et seq.), requiring bidders to certify they are not Iran-linked businesses as defined under the Act. Bidders who submit false certifications face significant penalties, including contract termination, a three-year bidding ineligibility period, and civil penalties of $250,000 or twice the bid amount, whichever is greater, plus investigation and legal costs. The certification must be notarized before a notary public in the bidder's state and county, with the notary's signature, seal, expiration date, and acting county clearly documented on the form.
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Other files
| File | Type | Posted |
|---|---|---|
| Instruction to Bidders.pdf | ||
| Attach C Familial Statement_.pdf | ||
| Acc Attachment A Project Description_.pdf | ||
| Attach B Bid Form.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 .