7-Contractor Employee Background Certification Form 2024.pdf
PDF 193 KB Posted
- Attached to
- Food Service Equipment
- Solicitation number
- 1104-B-2526
- Issued by
- Portsmouth City, Virginia
About this file
This is a Contractor Employee Background Certification form from Portsmouth Public Schools in Virginia. The document requires contractors bidding on school-related services to complete a certification verifying that their company and employees who will have direct contact with students have never been convicted of specific serious criminal offenses. The form specifically requires certification that no employees have been convicted of felonies, sexual offenses involving children, or crimes of moral turpitude.
The certification is mandatory and directly tied to bid responsiveness, with a clear stipulation that failure to return this completed form with the bid will result in the bid being considered non-responsive. The form must be signed by an authorized company representative and includes spaces for signature, printed name, company name, business address, and date. The certification is aligned with the Code of Virginia § 22.1-296.1, which appears to be a statutory requirement for protecting student safety in school-related contracts.
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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 .