Fingerprinting Certification Form Summary

This is a fingerprinting certification form issued by the County of San Mateo's Contract Compliance Committee, applicable to the Provider Time Tracking, Invoicing and Approval procurement for San Mateo Medical Center. The form establishes a requirement that all contractor employees, subcontractors, assignees, and volunteers who have contact with children during the course of service delivery must undergo fingerprinting to determine criminal history and ensure child safety. The document serves as a template that contractors must complete, providing spaces for the date of agreement, contractor name, signatory title, signature, and date of issuance. The form was established effective July 1, 2013, and represents a mandatory compliance certification that prospective vendors must acknowledge and fulfill as a condition of contract award.

This fingerprinting certification requirement applies specifically to the five-year Provider Time Tracking, Invoicing and Approval software services contract, with proposals due April 1, 2026. While the fingerprinting form does not directly address pricing, set-asides, or funding sources, it represents a critical pre-award compliance requirement that contractors must satisfy. The form functions as part of the broader County of San Mateo procurement compliance framework, ensuring that any personnel with child contact during service delivery operations meets background screening standards. This requirement is particularly relevant given SMMC's operations include pediatric outpatient clinics and long-term care facilities serving San Mateo County residents.