1-Workmens Compensation.pdf

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Attached to
State Theatre External Rehabilitation
Solicitation number
Not on record
Issued by
Fulton County, Pennsylvania

About this file

This is a Workmen's Compensation Affidavit document related to the State Theatre External Rehabilitation project, a construction contract opportunity issued by the Redevelopment Authority of the City of Uniontown, Pennsylvania. The affidavit certifies that contractors have accepted the provisions of Pennsylvania's Workmen's Compensation Act of 1915 and have obtained required insurance coverage under the Act. Sealed bids for Contract No. C000083242 are due electronically via PennBid by the specified time on Wednesday, January 7th, 2026, with all bids to be reviewed by 4:00 PM that same day at 20 North Gallatin Avenue, Suite 216, Uniontown, PA 15401. A non-mandatory pre-bid conference will be held at the project site at 11:00 AM on December 22nd, 2025. Bids must be accompanied by a bidder's bond or certified check in the amount of not less than 10%, and bidders must submit a non-collusion affidavit with their proposals. No bid may be withdrawn for sixty days following submission.

The project is funded through the Community Development Block Grant Program and is subject to all related federal regulations, including federal prevailing wage requirements. The Redevelopment Authority reserves the right to waive any informality and to accept or reject any and all bids. Contractors must demonstrate compliance with Pennsylvania's Workmen's Compensation Act through this affidavit, which requires documentation of accepted provisions and appropriate insurance coverage with an identified company.

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Text version

AFFIDAVIT RE

ACCEPTING PROVISIONS OF THE WORKMEN’S COMPENSATION ACT

State of )

) ss:

County of )

Being duly sworn according to law deposes and says that they have accepted the provisions of the Workmen’s Compensation Act of

1915 of the Commonwealth of Pennsylvania, with its supplements and amendments, and has insured their liability thereunder in accordance with the terms of said Act with .

(COMPANY)

(TYPE OR PRINT) CONTRACTOR

BY:

File details come from the government source that posted it. Updated .