Fingerprinting_Certification_Form.pdf

This is a Fingerprinting Certification Form issued by the County of San Mateo, applicable to contractors and service providers working with the county's agencies, including San Mateo Medical Center. The form establishes a requirement that all employees, subcontractors, assignees, and volunteers who have contact with children during the performance of services under a county agreement must undergo fingerprinting. The fingerprinting process is conducted to determine whether individuals have a criminal history that would compromise the safety of children served by the county. The form includes fields for the date of agreement, contractor name, employee or representative name and title, and signature and date of the authorizing official.

No specific pricing terms, set-asides, or funding information is provided in this certification form. The document serves as a compliance and safety requirement rather than a procurement specification document. The form was issued by the County of San Mateo Contract Compliance Committee on July 1, 2013, and applies as a standard condition to contracts involving services where contractor personnel may have contact with children. Completion and submission of this form appears to be a mandatory prerequisite for contract execution when such contact is anticipated.