Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo's Contract Compliance Committee, effective July 1, 2013, applicable to contractors providing services to San Mateo Medical Center (SMMC), a public hospital and clinic system in California. The form establishes requirements for background screening of contractor personnel who will have contact with children during the performance of services under county agreements. The certification mandates that all employees, subcontractors, assignees, and volunteers of the contractor must undergo fingerprinting to identify any criminal history that could compromise child safety. The form serves as a template for documenting contractor agreement to these fingerprinting requirements and includes spaces for the agreement date, contractor name, signatory information, title, and signature.

The form does not specify pricing terms, set-asides, funding sources, or contract duration details. Rather, it functions as a compliance and safety requirement document that must be executed as part of the broader contracting process with San Mateo County. The fingerprinting certification represents a standard condition precedent for any contractor whose personnel will interact with children in the course of performing contracted services for county entities. No renewal options, incumbent information, or specific financial requirements are detailed within this certification form.