Fingerprinting_Certification_Form.pdf

PDF 587 KB Posted

Attached to
Wander Management System
Solicitation number
66000-2526-233
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, applicable to contractors and service providers working with San Mateo Medical Center. The form establishes a requirement that all contractor employees, subcontractors, assignees, and volunteers who have contact with children during the performance of services must undergo fingerprinting to screen for criminal history that could compromise child safety. The form is a template document dated July 1, 2013, containing fields for the agreement date, contractor name, signatory name and title, and execution date. This certification requirement applies to the Wander Management System procurement, a comprehensive solution for preventing unauthorized patient wandering at San Mateo Medical Center with real-time monitoring and staff alert capabilities. The system must integrate with existing hospital infrastructure including the EPIC Electronic Health Record System and Voalte Nurse Call System, with proposals due February 20, 2026 at 1:00 PM via the eProcurement system. The contract term is five years.

Vendors must meet substantial compliance and credentialing requirements, including background security checks, HIPAA adherence, Americans with Disabilities Act provisions, and compliance with San Mateo County Living Wage Ordinance and Equal Benefits Ordinance. Vendors must demonstrate five years of experience providing similar services and maintain cyber liability insurance of $5,000,000 per occurrence. The evaluation criteria allocate 30 points to project approach, 25 points to firm qualifications, 20 points to team qualifications, and 25 points to price. Local business and non-profit preferences provide up to 10 percent additional preference points based on certification status. The County reserves the right to reject any proposals and will award to the most responsive, responsible proposer offering the best overall value rather than the lowest price. No specific total contract value is stated, though the Sample Service Agreement template references contracts exceeding $200,000.

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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 .