Skip to content
The COVID Project
  1. Library
  2. Federal commerce, travel, workplace and finance layer
  3. FED-278

Ex. FED-278 Order Primary source read

Certification of Vaccination form (employees, onsite contractors and visitors), August 2021

Certification of Vaccination

Safer Federal Workforce Task Force (OMB control number 3206-0277) · United States (federal buildings) (Federal)

The COVID Project

The record

Jurisdiction
United States (federal buildings)
Level
Federal
Authority
Executive Order 13991; the July 29, 2021 Model Safety Principles; 18 U.S.C. § 1001 (false statements)
Issued
2021-08-06 Aug. 6, 2021
Effective
August 2021 (read as 2021-08-06)
End
2022 (superseded) (read as 2021-09-30)
In force
Aug. 6, 2021 to Sept. 30, 2021
Quarters
2021 Q3
Limitation types
Workplace rulesVaccination or testing
Addressees
  • federal employees
  • onsite contractors
  • visitors to federal buildings
Functions reached
  • CS visitor and vendor entry to federal buildings
  • PL onsite contractors
Collection
Federal commerce, travel, workplace and finance layer FED-B

Operative words

I am a visitor or I am an onsite contractor who is not enrolled in an agency's testing program... [a] contractor making a false statement on this form could result in additional administrative action, including removal from a contract.

Enforcement

administrative action; removal from contract; 18 U.S.C. § 1001 warning

Notes

The form every vendor, contractor and visitor to a federal building was asked to complete from August 2021.

Retrieval note

Retrieved from the Wayback Machine capture of Aug. 6, 2021.