GenNET Fiber Maintenance RFP 2018 - 04 - Attachment C - Familial Statement.pdf
PDF 13 KB Posted
- Attached to
- Fiber Maintenance
- Solicitation number
- RFP GIS 190000000453 2
- Issued by
- Genesee County, Flint City, Michigan
About this file
This is a Familial Relationship Disclosure Statement required by the Genesee Intermediate School District in Flint, Michigan, for the GenNET Fiber Maintenance RFP 2018-04. The statement is mandated under Public Act 232 of 2004 and must accompany all bids submitted in response to this opportunity. All contractors, vendors, and respondents are required to disclose any familial relationships or other business relationships existing between the bidder, its employees, and members of the Genesee Intermediate School District Board of Education, the District Superintendent, or any other District official. Bids that do not include a completed, sworn, and notarized familial relationship disclosure statement will not be accepted.
The form requires the contractor or vendor to provide their name, address, and contact number, followed by a detailed statement of any business or familial relationships with District officials or employees. The authorized representative of the bidding entity must sign and date the statement, which must then be notarized by a Notary Public. The notary must complete all required certification information, including the county where the acknowledgment occurred, the date, and the expiration date of the notary's commission. This disclosure requirement ensures transparency and compliance with Michigan state law regarding potential conflicts of interest in the procurement process.
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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 .