Fingerprinting Certification Form - County of San Mateo

This is a fingerprinting certification form issued by the County of San Mateo Contract Compliance Committee (effective July 1, 2013) that establishes requirements for contractors performing services under county agreements. The form documents an agreement requiring that all employees, subcontractors, assignees, and volunteers who have contact with children during service delivery must undergo fingerprinting to determine criminal history and ensure child safety. The form contains fields for the date of agreement, contractor name, signatory name and title, and signature date. This certification applies to the HRSA Service Area Competition (SAC) Application Support procurement (RFP No. 66000-2526-239) for San Mateo Medical Center, with proposals due March 27, 2026, at 1:00 pm. The selected vendor will provide professional services supporting HRSA grant application development and submission under a two-year agreement with no renewal options. No pre-proposal conference or site visit is scheduled.

The fingerprinting certification requirement represents a mandatory compliance provision for all contractors and must be satisfied prior to contract execution for any personnel with child contact. This requirement is part of the County's comprehensive contractor compliance framework and applies regardless of contract award value or pricing terms. The fingerprinting certification ensures compliance with child safety protocols and is enforceable across all County of San Mateo service contracts. Additional contractor requirements include general liability insurance of $1,000,000 per occurrence, workers' compensation insurance, HIPAA Business Associate Agreement compliance, Living Wage Ordinance adherence, and intellectual property assignment to the County. Vendors must be legally authorized to conduct business in California and registered with SAM.gov.