Statement of Familial Relationship_Van.docx
DOCX document 22 KB Posted
- Attached to
- CHRYSLER PACIFICA AWD
- Solicitation number
- RFP LCAS 260000001904 1
- Issued by
- Macomb County, Lansing City, Michigan
About this file
This is a Statement Regarding Familial Relationship form used by Lake City Area Schools for bidders on a Chrysler Pacifica AWD Van procurement. The form requires bidders to disclose any familial relationships between the contractor's owners and employees and the school district's superintendent and/or board members. Bidders must either list all existing familial relationships with the related parties' names and relationship descriptions, or declare that no such relationships exist. The form must be completed by an authorized representative of the bidding firm and notarized.
The document serves as a disclosure mechanism to ensure transparency and identify potential conflicts of interest in the bidding process. Completion and submission of this form is mandatory for bid evaluation, as the school district relies on the accuracy of the representations made by the bidder. The notarized statement binds the contractor to the accuracy of the familial relationship disclosures provided.
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Other files
| File | Type | Posted |
|---|---|---|
| 2026_School Vehicle Invitation to Bid.docx | DOCX document |
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Text version
Lake City Area Schools
STATEMENT REGARDING FAMILIAL RELATIONSHIP
| I am the | of | , a bidder on a |
| (Title) | (Company Name) |
Chrysler Pacifica AWD Van for Lake City Schools.
____ I have personal knowledge and/or I have personally verified that the following are all of the familial relationships existing between the owner(s) and employee(s) of the aforementioned contractor and the school district's superintendent and/or board members.
The following are the familial relationship(s):
Owner I Employee Name Related to: Relationship
1.
2.
3.
4.
5.
(Attach additional pages if necessary to disclose familial relationships)
I have authority to bind the aforementioned contractor with the representations contained herein, and I am fully aware that the school district will rely on my representations in evaluating bids for the construction project.
____ There is no familial relationship that exists between the owner(s) and employee(s) of the aforementioned contractor and the school district's superintendent and/or board members.
| BIDDER 'S FIRM NAME | BY (SIGNATURE) | PRINTED NAME AND TITLE | |
| Subscribed and sworn before me, this | Seal: |
day of ,20___, a Notary Public In and for County, MI
Signature
My commission expires
Statement of Familial Relationship - 1 of 1
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