7-Contractor Employee Background Certification Form 2024.pdf
PDF 193 KB Posted
- Attached to
- FOOD SERVICE FRESH BREAD
- Solicitation number
- 1105-B-2526
- Issued by
- Prince William County, Portsmouth City, Virginia
About this file
This is a Contractor Employee Background Certification Form required by the Virginia state government for the Fresh Bread Food Service contract opportunity. The certification confirms that the applicant firm and any employees who will have direct contact with students comply with Virginia Code 22.1-296.1 regarding background requirements. Contractors must certify that neither the firm nor its employees have been convicted of felonies, offenses involving sexual molestation or physical or sexual abuse or rape of a child, or crimes of moral turpitude.
The form must be completed, signed by an authorized representative, and submitted with the bid package. Failure to return this certification form with the bid will result in the bid being deemed non-responsive and ineligible for consideration. The form requires the signature, printed name of the signatory, company name, business address, and date of certification.
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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 .