2-Contractor Employee Background Certification Form 2024.pdf
PDF 193 KB Posted
- Attached to
- Grounds Maintenance
- Solicitation number
- 1106-B-2526
- Issued by
- Pittsylvania County, Portsmouth City, Virginia
About this file
This is a Contractor Employee Background Certification Form required for the Grounds Maintenance contract opportunity with the Virginia school district (PPS). The form mandates that the applicant firm and any employees who will have direct contact with students must certify compliance with Virginia Code 22.1-296.1. Contractors and their employees must declare that they have never been convicted of a felony, any offense involving sexual molestation, physical or sexual abuse, or rape of a child, nor any crime of moral turpitude. The completed and signed form must be submitted with the bid proposal.
Failure to return this certification form with the bid submission will result in the bid being deemed non-responsive and likely disqualified from consideration. The form requires the authorized representative's signature, printed name, company name, business address, and date of certification. This requirement applies to all contractors seeking to provide grounds maintenance services for the school district under this contract.
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Text version
CONTRACTOR EMPLOYEE BACKGROUND CERTIFICATION
I certify that the applicant firm is in compliance with the Code of Virginia § 22.1-296.1, regarding providing certification from the company and any employee that will come in direct contact with students, for the provision of services under this contract.
I certify that the applicant firm and any of its employees, that will come in direct contact with students, have (i) never been convicted of a felony or any offense involving the sexual molestation or physical or sexual abuse or rape of a child; nor (ii) convicted of a crime of moral turpitude.
BY_______________________________________________ (SIGNATURE)
_______________________________________________ (PRINTED NAME)
_______________________________________________ COMPANY
_______________________________________________ BUSINESS ADDRESS
_______________________________________________ DATE
This form must be completed and returned with your bid.
Failure to return this form with your bid will result in your bid being considered non responsive.
File details come from the government source that posted it. Updated .