Fingerprinting_Certification_Form.pdf
PDF 587 KB Posted
- Attached to
- Coding Services
- Solicitation number
- 66000-2526-232
- Issued by
- San Mateo County, San Francisco City, California
About this file
This is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee, dated July 1, 2013, applicable to contractors performing services for the county. The form establishes requirements for fingerprinting employees, subcontractors, assignees, and volunteers who will have contact with children during the course of service delivery. The certification agreement mandates that all personnel with child contact undergo fingerprinting to determine criminal history and assess potential risks to child safety. The form includes fields for the date of agreement, contractor name, service description, employee name, title, signature, and date of certification.
No additional pricing terms, set-asides, funding sources, or contract renewal options are specified in this certification form. The document serves as a compliance requirement and protective measure for contracts involving child contact, reflecting the county's commitment to child safety standards. This form appears to be a standard template used across San Mateo County contracts that involve services to vulnerable populations, particularly children.
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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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