10-2. Acknowledgement 2 Workers Compensation.pdf

This is a Workers' Compensation Acknowledgement form issued by the City of Chester, Pennsylvania for use in connection with municipal contract opportunities. The form serves as a declaration by prospective bidders that they are aware of Pennsylvania Labor Code requirements mandating employers maintain workers' compensation insurance or undertake self-insurance in accordance with state law. Bidders are required to acknowledge their compliance with these provisions before commencing performance of contracted work. The form requires completion of bidder company name, contact name, title, signature, and date of submission.

The Workers' Compensation Acknowledgement is a standard compliance document required as part of the bid submission package for the City of Chester's multiple procurement initiatives, which include refuse and recyclables collection services for approximately 9,900 residential customers (five-year term effective January 1, 2026, through December 31, 2030, with optional extensions through 2032), on-call towing services from two licensed and insured providers, and municipal parking management and enforcement services (two-year term with renewal option for Year 3). All prospective bidders must complete and submit this acknowledgement form along with other required certificates and disclosures as part of the comprehensive vetting process established by the City of Chester.