4-Contractor Employee Background Certification Form 2024.pdf
PDF 193 KB Posted
- Attached to
- Athletic Field Maintenance & Related Services
- Solicitation number
- 1107-B-2526
- Issued by
- Portsmouth City, Virginia
About this file
This is a Contractor Employee Background Certification Form required by Virginia for the Athletic Field Maintenance & Related Services contract opportunity with Petersburg Public Schools (PPS). The form mandates that bidding contractors and any employees who will have direct contact with students must certify compliance with Virginia Code 22.1-296.1 regarding background screening requirements. Contractors must affirm that neither the applicant firm nor any of its employees have been convicted of a felony, any offense involving sexual molestation or physical or sexual abuse or rape of a child, or any crime of moral turpitude.
Submission of the completed and signed certification form is mandatory with all bids. The form requires the signature, printed name, company name, business address, and date from an authorized representative of the bidding firm. Failure to return the completed form as part of the bid submission will result in the bid being deemed non-responsive and ineligible for consideration.
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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 .