Fingerprinting_Certification_Form.pdf

PDF 587 KB Posted

Attached to
Overpayment Resolution Services
Solicitation number
66000-2526-225
Issued by
San Mateo County, San Francisco City, California

About this file

The document is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee on July 1, 2013. This is a sample form designed to ensure the safety of children by requiring contractors, their employees, subcontractors, assignees, and volunteers who have contact with children during the course of performing services under an agreement to be fingerprinted.

The form requires the contractor to certify that individuals who will have contact with children will undergo a criminal background check through fingerprinting. The purpose is to determine whether any of these individuals have a criminal history that could potentially compromise the safety of children. The form includes blank fields for the date of the agreement, the name of the agreement partner, the contractor's name, title, and signature, indicating it is a template to be completed for specific contract engagements involving child-related services.

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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...

File details come from the government source that posted it. Updated .