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AgdaPkt 2018-10-01 Joint SA PFA
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AgdaPkt 2018-10-01 Joint SA PFA
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Last modified
10/2/2018 9:21:59 AM
Creation date
9/27/2018 4:55:21 PM
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Template:
CC Index
CC Index - Document Type
Agenda Packet
Meeting Type
Joint
Agency Type
City Council and Successor Agency and Public Financing Authority
Date
10/1/2018
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Exhibit “D” <br />(Criminal Background and Fingerprint Form) <br /> <br />PROJECT/CONTRACT NO.: between the City of Redwood <br />City (“City”) and (“Contractor” <br />or “Bidder”) (“Contract” or “Project”). <br />The undersigned does hereby certify to the City as follows: <br />1. That I am a representative of the Contractor currently under contract with the City; <br />that I am familiar with the facts herein certified; and that I am authorized and <br />qualified to execute this certificate on behalf of Contractor. <br /> <br />2. Contractor certifies that it has taken the following action with respect to the <br />construction Project that is the subject of the Contract and located at the property <br />owned and operated by the Redwood City School District (“District”): <br /> Pursuant to Education Code section 45125.2, Contractor has installed or <br />will install, prior to commencement of Project, a physical barrier at the <br />Project Site, that will limit contact between Contractor's employees and <br />District pupils at all times. <br /> <br /> <br />Date: <br />Proper Name of Contractor: <br />Signature: <br />Print Name: <br />Title: <br /> <br />A copy of this executed form shall be provided to the Redwood City School District. <br /> <br />REV: 07-27-18 PR <br />ATTY/AGR/2018.162/REDWOOD CITY SCHOOL DISTRICT - STMMA <br />Page 23 of 23 <br />6.1.B. - Page 28
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