Fingerprinting_Certification_Form.pdf

PDF 587 KB Posted

Attached to
Reimbursement Consulting Support Services
Solicitation number
66000-2526-247
Issued by
San Mateo County, San Francisco City, California

About this file

This is a Fingerprinting Certification Form issued by the County of San Mateo Contract Compliance Committee, effective July 1, 2013. The form establishes requirements for contractors and their employees, subcontractors, assignees, and volunteers who will have contact with children during the performance of services under County agreements. The form requires that all personnel with child contact undergo fingerprinting to determine criminal history and assess whether such history would compromise child safety. The document includes fields for the agreement date, contractor name, employee name and title, and signature with date of certification.

The form serves as a compliance mechanism to protect children through background screening requirements. No specific pricing terms, award dates, contract duration, or renewal options are addressed in this certification document, as it functions as a standard safety requirement applicable to covered County contracts. The fingerprinting certification applies to all contractor personnel and subcontractors assigned to work involving child contact, with no exceptions noted for incumbents or other categories. This requirement aligns with the County's broader commitment to child safety across all service delivery agreements.

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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...

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