Familial_Disclosure_Statement.pdf
PDF 267 KB Posted
- Solicitation number
- RFP CSP 190000000335 3
- Issued by
- Kent County, Cheboygan City, Michigan
About this file
This is a Familial Relationship Disclosure Statement required by Cedar Springs Public Schools in compliance with Michigan Code of Laws (MCL 380.1267). All bidders submitting proposals must complete and return this notarized document with their bid submission. The statement requires disclosure of any familial relationships existing between the bidder's owner or employees and members of the Cedar Springs Public Schools Board or the Superintendent. Bidders must list each related individual, the board member or superintendent they are related to, and the nature of the relationship. If no familial relationships exist, bidders must certify this fact in writing.
The completed disclosure statement must be sworn and notarized, with the bidder representative's signature, printed name, and title included. The notary public must acknowledge the instrument and provide their signature, commission expiration date, and acting county. Failure to return the completed and properly notarized statement with the bid submission will result in automatic bid disqualification. Additional pages may be attached if necessary to disclose all familial relationships.
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Text version
FAMILIAL RELATIONSHIP DISCLOSURE
(MUST return completed and notarized with bid)
Pursuant to MCL 380.1267, a sworn and notarized statement disclosing any familial relationship that exists between the owner or any employee of the bidder and any member of the Cedar Springs Public Schools Board or the Cedar Springs Public Schools’ Superintendent must be accompanied with the bid. Failure to return this notarized statement/signature with the bid will result in bid disqualification.
The following are the familial relationship(s):
Owner/Employee Name Related to: Relationship_________
1. _______________________ ________________________ ___________________________
2. _______________________ ________________________ ___________________________
3. _______________________ ________________________ ___________________________
4. _______________________ ________________________ ___________________________
5. _______________________ ________________________ ___________________________ Attach additional pages if necessary to disclose all familial relationships.
□ There is no familial relationship that exists between the owner or any employee of the bidder and any Member of the Cedar Springs Public Schools Board, or the Cedar Springs Public Schools’ Superintendent.
The undersigned, the owner or authorized representative of bidder (insert name) _________________________ does hereby Represent and warrant that the disclosure statements herein contained are true.
Print Name Signature of Bidder Representative
Title
STATE OF MICHIGAN )
) ss
COUNTY OF ______________)
This instrument was acknowledged before me on the _____ day of _________________, _______, By ______________________________________________.
Notary Public
_________________County, Michigan My commission expires: ____/____/____ Acting in the County of: _____________
File details come from the government source that posted it. Updated .