Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form from the County of San Mateo, issued by the County of San Mateo Contract Compliance Committee on July 1, 2013. The form establishes requirements for contractors performing services under agreements with San Mateo County entities, including San Mateo Medical Center. The form certifies that contractor employees, subcontractors, assignees, and volunteers who have contact with children during the course of service delivery must undergo fingerprinting to determine whether they have a criminal history that could compromise child safety. The document is a template form designed to be completed with the agreement date, contractor name, signatory name and title, and signature and date of the responsible party.

This certification form represents a mandatory compliance requirement rather than a standalone procurement document. It functions as a protective measure integrated into the contracting process for any services that involve potential contact with children. Organizations bidding on County of San Mateo contracts, particularly those related to healthcare or social services such as the referenced Outpatient Rehabilitation Outcome Measure opportunity, must acknowledge and comply with the fingerprinting requirements for their personnel. No pricing terms, funding amounts, or contract award information are contained in this certification form.