Familial Disclosure Form.pdf
PDF 399 KB Posted
- Attached to
- Food service equipment
- Solicitation number
- RFP-DCS-250000001349-1
- Issued by
- Genesee County, Michigan
About this file
This document is a Familial Disclosure Form required by Davison Community Schools in Davison, Michigan for construction bid submissions. The form requires bidders to disclose any familial relationships that exist between the owner(s) or employees of the bidding company and any member of the School District's Board of Education or Superintendent.
The form must be completed by an authorized officer of the bidding company, notarized, and submitted as Section 004200.1 of the bid package. It includes fields for listing specific familial relationships (if any exist), requiring the name and relation of any such connections. The document must be executed under oath before a notary public in the State of Michigan, with the notary's county of operation and commission expiration date included.
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Text version
FAMILIAL DISCLOSURE FORM
Davison Community Schools
Davison, Michigan
SECTION 004200.1
FAMILIAL DISCLOSURE FORM
AFFIDAVIT OF BIDDER - #1
The undersigned, the owner or authorized officer of ____________________ (the “Bidder”), pursuant to the familial disclosure requirement provided in the _____________________ (the “School District”) advertisement for construction bids, hereby represent and warrant, except as provided below, that no familial relationships exist between the owner(s) or any employee of ______________________ and any other member of the Board of Education of the School District or the Superintendent of the School District.
List any Familial Relationships:
Name: __________________________________ Relation: _______________________________
Bidder: _________________________
By: _____________________________
Its: _____________________________
Date:____________________________
STATE OF MICHIGAN_________ )
) ss
COUNTY OF __________________)
This instrument was acknowledged before me on the ______ day of _____________ in the year
_________, by ________________________________.
Notary Public
______________________ County, Michigan
My Commission Expires: ________________
Acting in the County of: ________________
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