COVID_19_Vaccine_Policy_Attestation_(8).docx
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- Attached to
- CAO Criminal Case Management System
- Solicitation number
- 306
- Issued by
- Los Angeles County, San Francisco City, California
About this file
This is a COVID-19 Vaccination Policy Attestation document prepared for the City of Santa Monica, California, to be executed and incorporated into service agreements between the City and contractors. The attestation requires all contractor personnel and subcontractors assigned to perform services at City of Santa Monica facilities, or who will interact with City employees or residents during service delivery, to be fully vaccinated in accordance with the City's COVID-19 Vaccination Policy. Contractors must maintain documentation of vaccination status for all assigned personnel and subcontractors throughout the contract term and make such documentation available to the City for inspection upon written request within ten days. The attestation must be signed by an authorized representative of the contractor and include the signatory's name, title, signature, date, email, and phone number.
Failure to comply with the vaccination policy or to permit City inspection of required documentation constitutes a material breach of the agreement and provides grounds for contract termination. The contractor must obtain written authorization from personnel and subcontractors prior to submitting their vaccination documentation to the City. The attestation applies to the specific contract referenced in the document and is binding on the contractor, its personnel, and any subcontractors involved in performance of the contracted services.
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Text version
THIS COVID-19 ATTESTATION MUST BE EXECUTED &
SUBMITTED TO CITY AND MADE PART OF AGREEMENT NO. ______.
Contractor attests that all of Contractor’s personnel and subcontractors assigned to perform the Services who will either visit or work in City of Santa Monica facilities, or interact with either City of Santa Monica employees or residents, in the course of performing said Services shall be fully vaccinated as defined in the City’s COVID-19 Vaccination Policy (“VP”), a copy of which is attached as Exhibit ___ to the Agreement under which Contractor, Contractor’s personnel, and/or subcontractors will perform the Services.
Contractor further attests that such personnel and subcontractors have produced to Contractor one of the forms of documentation set forth in the VP. Contractor shall maintain the underlying documentation establishing that such personnel and subcontractors are fully vaccinated and supporting the attestation for the term of the Agreement. Contractor agrees that Contractor will make such documentation available to the City for inspection on demand. Contractor agrees that it will obtain written authorizations from personnel and subcontractors prior to submitting the documentation to City.
Contractor further understands and agrees that failure to comply with the VP, or to permit the City to inspect the documentation to verify compliance with the VP within 10 days after the City’s written request for such documentation, shall constitute a breach of the Agreement and will be grounds for termination.
The undersigned, on behalf of himself or herself individually and on behalf of Contractor, hereby attests that he or she has read and understands the VP and its applicability to the Agreement. The undersigned further attests that he or she is authorized to execute this attestation on behalf of Contractor.
Prepared by: ____________________________Title: ________________________ Signature: ______________________________________ Date: _______________ Email: ____________________________________ Phone: ____________________ image1.jpeg
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