1-Contractor Certificate Regarding Workers Comp.pdf

This is a Contractor's Certificate Regarding Workers' Compensation for the State of California's Electronic Health Record System procurement. The certificate serves as a compliance document that bidders must complete and submit as part of their proposal submission. The form requires bidders to acknowledge their awareness of California Labor Code section 3700, which mandates that every employer carry workers' compensation insurance or undertake self-insurance in accordance with state provisions. Bidders must certify their commitment to comply with these workers' compensation requirements before commencing performance of work under the contract. The certificate includes signature blocks for up to five bidders, with fields for each bidder's name, signature, title, and date of execution.

The document functions as a mandatory certification requirement within the RFP process for the Electronic Health Record System project. Completion and submission of this certificate prior to contract award is essential for bid compliance and demonstrates the bidder's understanding of and commitment to California's workers' compensation insurance obligations. Failure to submit this certification or non-compliance with the stated workers' compensation requirements may result in bid rejection or contract termination.