Familial Disclosure Statement.pdf
PDF 160 KB Posted
- Solicitation number
- RFP - ADVA - 240000001380
- Issued by
- Wayne County, Dearborn City, Michigan
About this file
The provided document is a Familial Disclosure Statement that is required to be submitted with a bid for a state and local contract opportunity in Michigan. The contract opportunity is for a "New Multifunction School Activity Bus RFP - FY 24" and involves the jurisdictions of Wayne County and Dearborn City. The statement requires the bidder to disclose any familial relationships between the bidder's owner/employees and the members of the Advanced Technology Academy School Board or Superintendent/CAO. The bidder must attest that the provided information is true and accurate, and the statement must be signed and notarized.
The pricing terms, set asides, incumbent information, funding requirements, and other salient details about the contract opportunity are not provided in this specific document. The information summarized here pertains only to the Familial Disclosure Statement requirement for this particular solicitation.
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Text version
BID DISCLOSURE STATEMENT – FAMILIAL RELATIONSHIP
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 Advanced Technology Academy School Board or the Advanced Technology Academy's Superintendent/CAO must be accompanied with the bid.
The members of the Advanced Technology Academy are: Steven Borich, Dr. Janice Gilliland, Kenneth Williams, Marquis Scott and Kevin Ford.
The Advanced Technology Academy's Superintendent/CAO is: Barry Hawthorne
� The Following are the familial relationships:
� There are none.
STATE OF MICHIGAN )
) ss
COUNTY OF_____________)
The undersigned, authorized representative of bidder (insert name) __________________ does hereby acknowledge that bidder has read the foregoing disclosure statement and the statements herein contained are true.
Signature of Bidder Representative
Print Name
Title
Subscribed and sworn to before me this _____day of ___________________, ________.
Notary Public, _______________________County, Michigan
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