Familial Relationship disclosure.doc
DOC document 26 KB Posted
- Attached to
- RFP for Copy Machines
- Solicitation number
- RFP MNA 200000000082 2
- Issued by
- Wayne County, Michigan
About this file
This is a Familial Relationship Disclosure Statement required by Public Act 232 of 2004 for bids submitted to Melvindale-Northern Allen Park Public Schools. All bidders must submit a sworn and notarized statement accompanying their bids that discloses any familial relationships existing between the owner or any employee of the bidding company and any member of the Board of Education or Superintendent of Schools for the participating school district. The disclosure form requires bidders to represent and warrant that no such familial relationships exist, or if they do exist, to provide a detailed explanation of the relationship on the form.
The statement must be notarized and signed by the bidder or authorized officer, with attestation by a notary public including the date, county, and notary commission expiration date. This disclosure requirement applies uniformly to all bids submitted for opportunities with Melvindale-Northern Allen Park Public Schools and serves as a conflict-of-interest verification mechanism for the procurement process.
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| RFP for Copy Machines.docx | DOCX document |
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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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