GenNET Backup Equipment RFP 2019 - 04 - Attachment C - Familial Statemen....pdf
PDF 13 KB Posted
- Attached to
- GenNET Backup Equipment
- Solicitation number
- RFP-GIS-190000002755-1
- Issued by
- Genesee County, Michigan
About this file
The document is a Public Act 232 of 2004 Familial Relationship Disclosure Statement issued by the Genesee Intermediate School District (GISD) located in Flint, Michigan. This form is a mandatory attachment for bidders participating in a procurement process, requiring vendors to disclose any familial or business relationships between their company, employees, and GISD board members, the superintendent, or other district officials. Bids submitted without this sworn and notarized statement will not be accepted.
The disclosure statement requires potential contractors/vendors to provide their company name, address, contact information, and a detailed statement of any existing business or familial relationships with GISD personnel. The form includes spaces for the authorized representative to sign and have the document notarized, with specific provisions for county, state, and notary public documentation. This form serves as a transparency mechanism to prevent potential conflicts of interest in the school district's procurement processes.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
GENESEE INTERMEDIATE SCHOOL DISTRICT
ERWIN L. DAVIS EDUCATION CENTER
2413 WEST MAPLE AVENUE
FLINT, MI 48507-3493
PUBLIC ACT 232 OF 2004
FAMILIAL RELATIONSHIP DISCLOSURE STATEMENT
All bids must be accompanied by a sworn and notarized statement disclosing any familial, or other business relationship existing between the bidder (respondent to this Bid) and all employees of the bidder and any member of the Genesee Intermediate School District Board of Education, the Superintendent of the District and/or any other official of the District. Any bids that do not include this sworn and notarized statement shall not be accepted.
Owner Name & Address:
Genesee Intermediate School District 2413 West Maple Avenue
Flint, MI 48507-3493
Contractor/Vendor/Respondent Information:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Contact Number: ______________________________________________________________
Statement of Business or Familial Relationship:
Person Authorized to Bind the Contractor/Vendor/Respondent:
Print Name Title
Signature Date
Seal:
This instrument was acknowledged before me, a Notary Public, in and for ___________________________ County, _____________________ on this _________ day of ________________________, 20_________.
State
Notary Public Signature Date
My Commission Expires: _______________________
Acting in the County of: ________________________
Attachment C
File details come from the government source that posted it. Updated .