Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo's Contract Compliance Committee, applicable to contractors and service providers working with the County of San Mateo. The form establishes a requirement that all employees, subcontractors, assignees, and volunteers who have contact with children during the performance of services under a County agreement must undergo fingerprinting to determine whether they have a criminal history that could compromise child safety. The form is a template document issued July 1, 2013, and requires completion with the agreement date, contractor name, signatory name and title, and signature with date. This certification requirement applies specifically to the dental laboratory services agreement between the County of San Mateo and prospective dental lab contractors, as fingerprinting may be necessary depending on the specific roles and responsibilities of contractor personnel.

The fingerprinting certification is a mandatory compliance requirement rather than a pricing or funding document. Contractors must ensure that all personnel with child contact comply with this fingerprinting requirement as a condition of contract performance. This certification form is one of several compliance documents that prospective dental laboratory contractors must complete, alongside Section 504 Compliance forms, health care program exclusion list verification, HIPAA regulations adherence, and Living Wage Ordinance compliance documentation. The fingerprinting requirement protects vulnerable populations and is a standard safeguard implemented across County of San Mateo procurement activities.