Familial Disclosure Affidavit.pdf
PDF 87 KB Posted
- Attached to
- FY27 USF Bid
- Solicitation number
- RFP WLC 260000002423 1
- Issued by
- Berrien County, Michigan
About this file
This is a Familial Disclosure Affidavit required by the Walled Lake Consolidated School District in Michigan for its Invitation for Bids for the Purchase of Musical Instruments. The affidavit requires bidders to disclose any familial relationships between the bidder's owner or employees and members of the School District's Board of Education or Superintendent. The form provides space for bidders to list the bidder's name, authorized officer information, and any familial relationships that exist. The affidavit must be notarized and include the notary's certification and commission expiration date.
The document serves as a conflict-of-interest disclosure mechanism to ensure transparency and prevent favoritism in the procurement process. Bidders are required to warrant that no familial relationships exist except as specifically listed on the form. The School District provides a reference to its website at http://www.wlcsd.org where bidders can access the current list of Board of Education members and the Superintendent to verify potential conflicts. This affidavit is a standard compliance requirement that must be completed and submitted as part of the bidding process for musical instrument purchases.
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| Iran Economic Sanctions Act Affidavit.pdf | ||
| FY27 RFP Walled Lake IA.pdf |
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Text version
FAMILIAL DISCLOSURE AFFIDAVIT
The undersigned, the owner or authorized officer of ________________________ (the “Bidder”), pursuant to the familial disclosure requirement provided in the Walled Lake Consolidated School District’s (the “School District”) Invitation for Bids for the Purchase of Musical Instruments, hereby represents and warrants that, except as provided below, no familial relationships exist between the owner or any employee of the Bidder, and any member of the Board of Education of the School District or the Superintendent of the School District. A list of the School District’s Board of Education Members and its Superintendent may be found at http://www.wlcsd.org.
List any Familial Relationships:
BIDDER:
By:
Its:
STATE OF )
) ss.
COUNTY OF ____________ )
This instrument was acknowledged before me on the _____ day of ____________, 20__, by
, Notary Public
______________ County, My Commission Expires:
Acting in the County of:
| STATE OF: |
| COUNTY OF: |
| BIDDER: |
| By: |
| Its: |
| Notary Public: |
| My Commission Expires: |
| Acting in the County of: |
| Bidder: |
| Relationships: |
| Day: |
| Month: |
| Year: |
| Name: |
| County: |
| State: |
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