13-1. Acknowledgement 1 Workers Compensation.pdf

This is a Worker's Compensation Acknowledgement form issued by the City of Chester, Pennsylvania for use in connection with the Chester Police Station - 3rd Floor Interior Renovations project. The form serves as a bidder acknowledgement that requires contractors to confirm their awareness of Pennsylvania Labor Code provisions mandating workers' compensation insurance coverage or self-insurance authorization prior to commencing work. The project involves approximately 1,500 square feet of renovation work on the 3rd floor of the Chester Police Station, including demolition, new drywall, new carpet, new lighting, painting, and incidental improvements. This is structured as a lump sum contract with Pennsylvania Prevailing Wage Project Rates applying. The Chester Police Station renovation is one of several concurrent contract opportunities being pursued by the City of Chester, with award anticipated in the third quarter of 2025 and a Notice to Proceed effective January 1, 2026.

The Worker's Compensation Acknowledgement form requires bidders to complete designated fields including company name, contact name, title, signature, and date of submission. This form is mandatory as part of the bid packet submission process and reflects the City of Chester's thorough vetting procedures for potential contractors. Completion and submission of this acknowledgement, along with other required certificates and documentation including sexual harassment and non-discrimination acknowledgments, bid bonds, non-collusion affidavits, and conflict of interest disclosures, are prerequisites for bid consideration on municipal projects in Chester, Pennsylvania.