Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo, applicable to contractors and service providers working with the county. The form establishes a requirement that all employees, subcontractors, assignees, and volunteers who have contact with children during the course of contract performance must undergo fingerprinting. The fingerprinting requirement is designed to screen for criminal history that could compromise child safety. The form includes fields for the date of agreement, the name of the agreement/contractor, the name and title of the signatory, and signature and date lines for authorization. The document was issued by the County of San Mateo Contract Compliance Committee on July 1, 2013, and serves as a sample template for use in county contracting.

This certification requirement applies specifically to the Provider Time Tracking, Invoicing and Approval contract opportunity with San Mateo Medical Center (SMMC), a public hospital and clinic system accredited by The Joint Commission that operates throughout San Mateo County. Any contractor responding to this opportunity must acknowledge and comply with the fingerprinting certification requirement if their staff will have any contact with children during service delivery. This is a mandatory compliance measure rather than an optional provision and represents a standard county requirement for child safety protection in contracts involving potential child contact.