11-00 45 26 Contractor Compliance with Workers Compensation Law DAP.pdf
PDF 72 KB Posted
- Attached to
- PW-Sewer Improvements to serve Alpha Ranch Master Infrastructure Sewer, City Project No. 105879
- Solicitation number
- 26-0057
- Issued by
- Tarrant County, Texas
About this file
This is a Standard Construction Specification document issued by the City of Fort Worth for Project No. 105879, Alpha Ranch Master Infrastructure Sewer improvements in Texas. The project involves the installation of approximately 28,191 linear feet of sanitary sewer pipe in varying diameters, including 5,437 LF of 30" pipe, 3,070 LF of 27" pipe, 780 LF of 24" pipe, 1,113 LF of 21" pipe, 5,514 LF of 18" pipe, 6,316 LF of 15" pipe, and 1,961 LF of 12" pipe. The specification document was revised on April 2, 2014, and establishes the contractual requirements for this public works sewer infrastructure project.
The document establishes contractor compliance requirements pursuant to Texas Labor Code Section 406.096(a), requiring all contractors to provide workers' compensation insurance coverage for all employees assigned to the project. Contractors must also provide certificates of compliance demonstrating workers' compensation coverage for all subcontractors, as mandated by Texas Labor Code Section 406.096(b). The specification includes a notarized certification section requiring the contractor's authorized representative to acknowledge compliance with these workers' compensation requirements before a notary public in Tarrant County, Texas.
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00 45 26 - 1
CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW
CITY OF FORT WORTH Alpha Ranch Master Infrastructure Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 105879
Revised April 2, 2014
SECTION 00 45 26 1
CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW 2
Pursuant to Texas Labor Code Section 406.096(a), as amended, Contractor certifies that it 4 provides worker’s compensation insurance coverage for all of its employees employed on City 5
Project No. 105879. Contractor further certifies that, pursuant to Texas Labor Code, Section 6
406.096(b), as amended, it will provide to City its subcontractor’s certificates of compliance with 7 worker’s compensation coverage. 8
CONTRACTOR: 10
_____________________________________ By: ___________________________________ 12
Company (Please Print) 13
_____________________________________ Signature: ______________________________ 15
Address 16
_____________________________________ Title: __________________________________ 18
City/State/Zip (Please Print) 19
THE STATE OF TEXAS § 22
COUNTY OF TARRANT § 24
BEFORE ME, the undersigned authority, on this day personally appeared 26
___________________________________, known to me to be the person whose name is 27 subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same as 28 the act and deed of ____________________________________ for the purposes and 29 consideration therein expressed and in the capacity therein stated. 30
GIVEN UNDER MY HAND AND SEAL OF OFFICE this ____________day of 32
_______________________, 20__. 33
__________________________________ 36
Notary Public in and for the State of Texas 37
END OF SECTION 39
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