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STATEMENT REGARDING FAMILIAL RELATIONSHIP

AFFIDAVIT OF _______________________________

(name of affiant)

STATE OF MICHIGAN

COUNTY OF _______________

______________________________makes this Affidavit under oath and states as follows:

1. I am a/the  President

 Vice-President

 Chief Executive Officer

 Member

 Partner

 Owner

 Other (please specify) __________________________________

Of ____________________________________, a bidder on a construction project for

(insert name of contractor)

_______________________________________ that involves, at least in part, construction

(insert name of school district)

of a new school building or an addition to or repair or renovation of an existing school

building.

2. 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 employees(s) of the

aforementioned contractor and the school district’s superintendent and/or board

members

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