Fingerprinting_Certification_Form.pdf

PDF 587 KB Posted

Attached to
Fixed and Removable Prosthesis for Dental Patients
Solicitation number
66000-2526-238
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, effective July 1, 2013. The form establishes requirements for contractors and their employees, subcontractors, assignees, and volunteers working on county agreements involving contact with children. The form requires fingerprinting of all personnel who will have contact with children during the course of performing services under the agreement to determine whether they have a criminal history that would compromise child safety. The form includes fields for the date of the agreement, the agreement holder's name and title, and signature authorization.

The form serves as a compliance document for any San Mateo County contract where contractor personnel will interact with children. No specific pricing, funding amounts, or contract term information is included in this certification form, as it functions as a prerequisite requirement rather than a standalone contract document. Contractors must complete and submit the form with their proposals or during contract execution. The fingerprinting requirement applies uniformly across all covered agreements regardless of contract value or duration.

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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 .