Familial_Disclosure_Statement.pdf

PDF 267 KB Posted

Attached to
Exterior doors & frames for school buildings with install
Solicitation number
RFP CSP 190000000336 3
Issued by
Kent County, Cheboygan City, Michigan

About this file

This is a Familial Relationship Disclosure Statement required by Cedar Springs Public Schools pursuant to MCL 380.1267. The document mandates that all bidders submit a sworn and notarized statement disclosing any familial relationships between the bidder's owner or employees and members of the Cedar Springs Public Schools Board or the Superintendent. The disclosure form provides space for bidders to list up to five familial relationships, with columns for the owner/employee name, the related board member or superintendent, and the nature of the relationship. Bidders may attach additional pages if necessary to disclose all relevant familial connections. Failure to return the completed and notarized statement with the bid submission will result in automatic bid disqualification.

The statement requires the bidder's owner or authorized representative to certify under oath that all disclosure information is accurate and truthful. The document must be notarized with the notary public's signature, seal, and expiration date clearly indicated, as well as the county in which the notarization is being performed. This disclosure requirement is a compliance mechanism designed to ensure transparency and prevent conflicts of interest in the procurement process for Cedar Springs Public Schools.

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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 .