Fingerprinting_Certification_Form.pdf
PDF 587 KB Posted
- Attached to
- Copying Services for Legal Imaging Request
- Solicitation number
- 66000-2627-272
- Issued by
- San Mateo County, San Francisco City, California
About this file
This is a Fingerprinting Certification Form related to San Mateo Medical Center's copying services contract for legal imaging requests in California. The form serves as a certification document for fingerprinting requirements associated with vendor participation in this contracting opportunity. The document establishes the procedural and compliance framework necessary for vendors to demonstrate eligibility and background clearance status as part of the proposal submission process for copying services related to legal imaging requests.
The fingerprinting certification form represents a pre-qualification requirement that vendors must complete and submit to San Mateo Medical Center. This certification requirement reflects the healthcare facility's commitment to maintaining security and compliance standards, particularly given the sensitive nature of legal imaging and copying services that may involve access to protected health information or confidential medical records. Vendors must satisfy this fingerprinting requirement as part of their overall bid submission and contract award eligibility criteria.
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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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