Fingerprinting_Certification_Form.pdf
PDF 587 KB Posted
- Attached to
- Purchase of a Furnished Mobile Dental Van
- Solicitation number
- 66000-2425-206
- Issued by
- San Mateo County, San Francisco City, California
About this file
The document is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee on July 1, 2013, which is associated with a broader contract opportunity for a mobile dental van purchase. The form requires contractors, their employees, subcontractors, assignees, and volunteers who will have contact with children during service performance to be fingerprinted to determine if they have a criminal history that could compromise child safety.
This certification form is part of the County of San Mateo's Healthcare for Homeless and Farmworkers Program procurement process for a mobile dental van. The contract opportunity seeks a fully equipped mobile dental van with 2-3 operatories/seats, budgeted between $300,000-$350,000, to provide comprehensive dental services in underserved communities. The county aims to receive the final furnished and operational vehicle by September 22, 2025, with the vehicle ready for immediate clinical use upon delivery.
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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 .