MANDATORY VACCINATION POLICY EFFECTIVE DECEMBER 14th, 2021

INSTRUCTIONS:
1. Please review, complete, and submit this Attestation on behalf of your Company/Contractor. Individual persons do not need to submit separate Attestations.
2. Submit your completed form no later than November 20th, 2021

Questions?  Please contact:

Scott Clark
Strategic Sourcing Department
St. Joseph's Healthcare Hamilton
sclark@stjoes.ca


By submitting this document, I attest that the Contractor named below complies with St. Joseph’s Healthcare Hamilton’s COVID-19 Vaccination Policy (Policy). I acknowledge and agree that compliance with the Policy is a term within the Contractor’s agreement with SJHH. Specifically, I attest that the Contractor named below is taking, and will continue to take, the following steps December 14th, 2021 forward:


1. Require and verify that all the Contractor's representatives working on-site at SJHH are fully vaccinated in compliance with the Policy against COVID-19 as may be approved by the Public Health Ontario.

2. Contractor will notify SJHH in the event Contractor intends to seek an accommodation for an individual who has an approved exemption, as verified by Contractor, prior to them working on any SJHH premises.

3. Contractor will provide documentation to validate vaccination status for any Contractor representative working on SJHH premises, upon SJHH’s request.

4. Contractor shall retain all required vaccination and exemptions documentation for Contractor representatives who work at SJHH, to be provided to SJHH upon request.

I attest that I have the authority to bind my organization.