Familial Relationship disclosure (1).doc
DOC document 26 KB Posted
- Solicitation number
- RFP-MNA-200000000081-2
- Issued by
- Michigan
About this file
This is a Familial Relationship Disclosure Statement form required by Public Act 232 of 2004 for Melvindale-Northern Allen Park Public Schools in Michigan. The document requires bidders to disclose any familial relationships that exist between the owner or employees of the bidding company and any member of the Board of Education or Superintendent of Schools of the participating school district.
The form must be submitted with bids and requires the bidder's signature, printed name, date, and notarization. If any familial relationships exist, bidders must explain them in the space provided on the form. The document serves as a sworn statement and must be notarized in the presence of a notary public within the state of Michigan.
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Text version
FAMILIAL RELATIONSHIP
DISCLOSURE STATEMENT
(This disclosure statement must be included with your bid as required by Public Act 232 of 2004)
All bids shall be accompanied by 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 Board of Education or Superintendent of Schools of the following participating school districts:
Melvindale-Northern Allen Park Public Schools
The undersigned, the owner or authorized officer of _______________________________________ (the “bidder”), pursuant to the familial disclosure requirement provided in the attached invitation to bid, hereby represent and warrant, except as provided below, that no familial relationships exist between the owner(s) or any employee of the company and any members of the Boards of Education and Superintendent of Schools as listed above. If such a relationship exists, please explain:
By: ________________________________________________________(Bidder’s signature)
Name: _______________________________________________________(type or print)
Date: _________________________________
Subscribed and Sworn to Before Me:
This ______________ day of ____________________, 20__ A.D., in and for the County of
____________________, Michigan. My commission expires: _________________________.
__________________________________ Signature of Notary
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