GISD - New Building Low Voltage 2019 - 04 - Attachment C - Familial Statement.pdf
PDF 13 KB Posted
- Attached to
- CCP New Building Low Voltage & AV Equipment
- Solicitation number
- RFP GIS 190000002251 3
- Issued by
- Genesee County, Flint City, Michigan
About this file
This is a Familial Relationship Disclosure Statement required by the Genesee Intermediate School District (GISD) in Flint, Michigan, as mandated by Public Act 232 of 2004. The document serves as a mandatory compliance requirement for all bidders responding to the "GISD - New Building Low Voltage 2019 - 04" contract opportunity. All bids must be accompanied by a sworn and notarized statement in which bidders disclose any familial or other business relationships existing between the bidder, all bidder employees, and any member of the GISD Board of Education, the District Superintendent, or any other District official. Bids submitted without this completed and notarized disclosure statement will not be accepted.
The form requires bidders to provide their company name, address, and contact information, followed by a detailed statement describing any business or familial relationships with District personnel. The authorized representative of the contractor, vendor, or respondent must sign and date the statement, which must then be acknowledged and sealed by a notary public in the county where the acknowledgment takes place. The notary must provide their signature, commission expiration date, and the county in which they are acting.
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 .