8-j. Certified Cleared Employee List.pdf

This is a Certified Cleared Employee List form required by Rockford Public School District No. 205 in Illinois for a diesel fuel procurement. The document serves as a certification that all employees of the vendor, supplier, professional services firm, or contractor have undergone required background checks, including a criminal history records check, a Statewide Sex Offender Database check, and a Statewide Child Murderer and Violent Offender Against Youth Database check in accordance with 105 ILCS 5/10-21.9. The vendor certifies under oath that all listed employees have not been convicted of any enumerated criminal or drug offenses and do not appear on the noted databases. The form includes a table for listing employee information by number, last name, middle initial, and first name, with a checkbox column for indicating criminal history database verification.

The form must be completed and sworn before a notary public, with the vendor's authorized representative (owner, officer, member, or partner) signing the certification. The document is not applicable if indicated by a checkbox and references Supplemental Terms and Conditions section 36 for additional requirements. This certification is a prerequisite compliance document for vendors bidding on the diesel fuel contract and must be submitted as part of the bid package.