Iran Linked Business Affidavit.pdf
PDF 347 KB Posted
- Solicitation number
- RFP MNA 200000000081 2
- Issued by
- Michigan
About this file
This is an Iran Linked Business Affidavit required by Melvindale-Northern Allen Park Public Schools for a bid related to an Interactive Display and Audio Enhancement System. The affidavit must accompany all bids submitted in response to this procurement opportunity. Bidders are required to provide a sworn statement disclosing any Iran Linked Business relationships that exist within the bidder's ownership structure, including officers, directors, and employees. The affidavit certifies compliance with Michigan Public Act No. 517 of 2012 and represents that neither the bidder nor any of its associated personnel constitute an "Iran Linked Business" as defined under applicable law. Bidders further warrant that they will not become an Iran Linked Business at any time during contract performance if awarded.
Bidders must acknowledge the civil and administrative penalties associated with submitting false certifications, including potential penalties of up to $250,000 or twice the contract amount, whichever is greater, plus investigation costs and attorney fees. Additionally, any person determined to have submitted a false certification becomes ineligible to bid on future district RFPs for a three-year period from the date of determination. The affidavit requires the bidder's authorized representative to sign and date the document, which must then be notarized before submission.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP interactive display and audio enhancement system.docx | DOCX document | |
| Familial Relationship disclosure.doc | DOC document |
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Text version
10/16/2019 1 of 1
IRAN LINKED BUSINESS AFFIDAVIT
All Bids shall be accompanied by a sworn statement disclosing any Iran Linked Business relationship that exists within the owners, including its officers, directors and employees.
The undersigned, owner or authorized officer of _________________________________ (the bidder), pursuant to Michigan Public Act No. 517 of 2012, the “Iran Linked Business” requirement provided in the Melvindale-Northern Allen Park Public Schools bid for Interactive Display and Audio Enhancement System, hereby represents and warrants that the bidder, including its officers, directors and employees, is not an “Iran Linked Business” within the meaning of the applicable Public Act, and that in the event bidder is awarded a contract as a result of this bid, the bidder will not become an “Iran Linked Business” at any time during the course of performing under the contract. The bidder further acknowledges that any person who is found to have submitted a false certification is responsible for a civil penalty of not more than $250,000.00 or 2 times the amount of the contract or proposed contract for which the false certification was made, whichever is greater, the cost of the District investigation, and reasonable attorney fees, in addition to the fine. Moreover, any person who submitted a false certification shall be ineligible to bid on future Requests for Proposals (RFPs) for three (3) years from the date that it is determined that the person has submitted the false certification.
There is not an “Iran Linked Business” that exists within the bidder and/or owner, officers, directors and employees.
Bidder: ____________________________________________________________ (Company Name)
By: ____________________________________________________________ (Signature)
(Title)
This instrument was acknowledged before me, a Notary Public, in and for
______________________ County, on this _____day of ___________________, 20__, ______________________________________________ SS:
(Notary Public Signature)
My Commission expires: __________________________
Acting in the County of: __________________________
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