Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee, applicable to contractors and service providers engaging with San Mateo Medical Center (SMMC), a public hospital and clinic system accredited by The Joint Commission. The form establishes a requirement that all contractor employees, subcontractors, assignees, and volunteers who have contact with children during the performance of services under the agreement must undergo fingerprinting to determine criminal history and ensure child safety. The form is a template document with fields for entry of the agreement date, contracting entity name, contractor name, title, signature, and date of execution.

The fingerprinting requirement serves as a mandatory compliance measure for child safety and is administered through the County of San Mateo's Contract Compliance Committee. The form applies to all personnel with direct or indirect contact with children in the course of contract performance and does not contain specific pricing terms, award dates, contract duration information, or renewal provisions, as it functions as a certification and compliance document rather than a primary contract or procurement solicitation document.