Iran Linked Business Disclosure for copy machine rfp.pdf
PDF 208 KB Posted
- Attached to
- RFP for Copy Machines
- Solicitation number
- RFP - MNA - 200000000082
- Issued by
- Wayne County, Menominee City, Michigan
About this file
The document is an Iran Linked Business Affidavit for a Request for Proposal (RFP) issued by the Melvindale-Northern Allen Park Public Schools in Wayne County, Michigan for the procurement of copy machines. The RFP requires bidders to disclose any Iran-linked business relationships within their ownership, including officers, directors, and employees. Bids are due on October 31, 2022 at 2:00 pm and must be delivered to the attention of Dave Patterson. The RFP covers the procurement of 2 copy machines for Allendale and 1 copy machine for Strong. The district reserves the right to reject any and all bids.
The affidavit states that any person who submits a false certification is subject to a civil penalty of up to $250,000 or twice the contract amount, in addition to investigation costs and attorney fees. A person who submits a false certification will also be ineligible to bid on future RFPs for 3 years. The affidavit requires the bidder to affirm that there is no Iran-linked business within the bidder and its ownership.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP for Copy Machines.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 Copy Machines (2 at Allendale and 1 at Strong), 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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