Fingerprinting_Certification_Form.pdf

PDF 587 KB Posted

Attached to
Group Purchasing Organization
Solicitation number
66000-2627-258
Issued by
San Mateo County, San Francisco City, California

About this file

This is a Fingerprinting Certification Form issued by the County of San Mateo's Contract Compliance Committee, effective July 1, 2013. The form establishes requirements for contractors and their employees, subcontractors, assignees, and volunteers who will have contact with children during the performance of services under a county agreement. The form requires certification that all personnel with child contact will undergo fingerprinting to determine criminal history and assess potential risk to child safety. The document serves as a template with designated fields for the agreement date, contracting party name, contractor name, title of authorized representative, and signature of the certifying official.

This fingerprinting requirement represents a mandatory safety compliance measure for all county contracts involving child contact. There are no pricing terms, renewal options, or specific funding requirements outlined in this certification form, as it functions as a prerequisite compliance document rather than a standalone contract. The form applies broadly to any contractor or subcontractor working with San Mateo County on agreements where employees or volunteers may interact with children, establishing a uniform background screening standard across all child-contact service contracts.

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Text version

County of San Mateo – Fingerprinting Certification Form

DATE: Click here to enter a date.

AGREEMENT WITH: Click here to enter text.

FOR:

Contractor agrees that its employees and/or its subcontractors, assignees and volunteers who, during the course of performing services under this agreement, have contact with children will be fingerprinted in order to determine whether they have a criminal history which would compromise the safety of children with whom contractors employees, assignees and subcontractors or volunteers have contact.

NAME: Click here to enter text.

TITLE: Click here to enter text.

SIGNATURE:

DATE:

Issued by County of San Mateo Contract Compliance Committee July 1, 2013

SAMPLE

Contractor agrees that its employees and/or its subcontractors, assignees and volunteers who, during the course of performing services under this agreement, have contact with children will be fingerprinted in order to determine whether they have a cri...

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