Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo that establishes requirements for contractor compliance with child safety screening procedures. The form serves as an agreement template requiring contractors, their employees, subcontractors, assignees, and volunteers who have contact with children during service delivery to undergo fingerprinting to determine criminal history and ensure child safety. The form includes fields for the date of agreement, contractor name, signatory title, signature, and date of issuance, and was published by the County of San Mateo Contract Compliance Committee on July 1, 2013.

This certification form applies to the After-Hours Pharmacy Remote Order Entry Services contract opportunity with San Mateo Medical Center, a public hospital and clinic system. While the pharmacy services contract does not explicitly involve direct child contact, San Mateo County may require this fingerprinting certification as a standard compliance requirement for all contractors and their personnel working within county healthcare facilities or with access to sensitive areas. Contractors responding to this opportunity must ensure that all applicable personnel comply with this certification requirement prior to contract award and service commencement.