GenNET Telephone Services RFP 2019 - 05 - Attachment D - Vendor Certification.pdf
PDF 14 KB Posted
- Attached to
- GenNET Telephone Service
- Solicitation number
- RFP GIS 200000000373 2
- Issued by
- Genesee County, Michigan
About this file
This is a vendor certification document from the Genesee Intermediate School District in Flint, Michigan, related to the GenNET Telephone Services RFP 2019-05. The document requires bidders to certify their compliance with Michigan's Iran Economic Sanctions Act (MCL 129.311 et seq.) prior to contract award. The certification must be completed by an authorized representative of the bidding contractor, vendor, or respondent and must be sworn and notarized before a notary public. Any bids submitted without this completed and notarized certification will not be accepted by the school district.
Bidders certify that they are not Iran-linked businesses as defined under the Act and acknowledge their understanding that submission of false certification may result in contract termination, ineligibility to bid for three years, a civil penalty of $250,000 or twice the bid amount (whichever is greater), and associated investigation and legal costs. The document requires the contractor to provide company name, address, contact number, and the printed name, title, signature, and date of the person authorized to bind the organization, along with notarization details including the notary public's signature, date, commission expiration, and the county in which the acknowledgment occurred.
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 517 OF 2012
IRAN ECONOMIC SANCTIONS ACT CERTIFICATION
I am the Click here to enter text of Click here to enter text, or I am bidding in my individual capacity ("Bidder"), with authority to submit a binding bid for the provision of Click here to enter text. services to Genesee Intermediate School District. I have personal knowledge of the matters described in this Certification, and I am familiar with the Iran Economic Sanctions Act, MCL 129.311, et seq. ("Act"). I am fully aware that the school district will rely on my representations in evaluating bids.
I certify that Bidder is not an Iran-linked business, as that term is defined in the Act. I understand that submission of a false certification may result in contract termination, ineligibility to bid for three (3) years, and a civil penalty of $250,000 or twice the bid amount, whichever is greater, plus related investigation and legal costs.
Any bids that do not include this sworn and notarized Certification 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: ______________________________________________________________
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 D
File details come from the government source that posted it. Updated .