Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee, effective July 1, 2013, applicable to contractors and their employees, subcontractors, assignees, and volunteers performing services under County agreements. The form establishes the requirement that all contractor personnel who have contact with children during the course of service delivery must undergo fingerprinting to determine whether they possess a criminal history that could compromise child safety. The form contains designated fields for the agreement date, contracting entity name, contractor name and title, and signature with corresponding date of execution.

The fingerprinting certification applies broadly to all contractor personnel with child contact, including direct employees, subcontractors, assignees, and volunteers. No specific pricing, funding sources, contract term, renewal options, or set-asides are detailed in this certification form, as it functions as a compliance requirement rather than a substantive contract document. The requirement serves as a mandatory safety screening mechanism for the County of San Mateo and relates to the Registry Contract opportunity with San Mateo Medical Center, a public hospital and clinic system operated by the County.