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Agmt12 County of San Mateo Alcohol and Drug Abuse Prevention Services - RWC 2020
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Agmt12 County of San Mateo Alcohol and Drug Abuse Prevention Services - RWC 2020
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Last modified
12/2/2013 2:53:06 PM
Creation date
10/22/2012 10:45:56 AM
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Agreement
Contractor Name
County of San Mateo and RWC 2020
PROJECT NAME
Alcohol and Drug Abuse Prevention Services FY 2012-2013
RMP File Number
304
Date
8/28/2012
MO Ref
12-151, 13-115
Amendment
Yes
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ATTACHMENT E <br /> FINGERPRINTING CERTIFICATION <br /> Contractor hereby certifies that Contractor's employees, volunteers, consultants, <br /> agents, and any other persons who provide services under this Agreement and <br /> who has/will have supervisory or disciplinary power over a child (Penal Code <br /> Section 11105.3) (the "Applicant") shall be fingerprinted in order to determine <br /> whether each such Applicant has a criminal history which would compromise the <br /> safety of children with whom each such Applicant has/will have contact. <br /> Contractor's employees, volunteers, consultants, agents, and any other persons <br /> who provide services under this Agreement: (check a or b) <br /> a. do NOT exercise supervisory or disciplinary power over children (Penal <br /> 11105.3). <br /> � b. do exercise supervisory or disciplinary power over children (Penal <br /> 11105.3). <br /> . ' , �`.. <br /> Name qf ontractor <br /> �, ,, � � `n ���� <br /> Signature o Authorized Official <br /> � ����c�v�"�I����1�� ��� ��� �-�� P�. �����I <br /> Name (please pr <br /> �'�Gl ��rl�,k- �I ►'�'(.�l��r <br /> Title (please print) <br /> ������� � � � <br /> '���Z-.� <br /> Date ` <br /> Page 19 of 20 <br />
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