18-Workmens Compensation Act.pdf
PDF 121 KB Posted
- Solicitation number
- Not on record
- Issued by
- Fayette County, Pennsylvania
About this file
This document is an Affidavit regarding acceptance of the Workmen's Compensation Act for the Commonwealth of Pennsylvania. The affidavit is a legal form that requires a contractor to confirm they have accepted the provisions of the Workmen's Compensation Act of 1915, including all subsequent supplements and amendments. The form provides space for the contractor to declare that they have insured their liability in accordance with the terms of the Act.
The affidavit is a standard legal document with blank spaces for the state, county, company name, and contractor signature. It serves as a formal attestation that the contractor has complied with Pennsylvania's workers' compensation insurance requirements, which is typically a mandatory step in contracting processes to protect workers and ensure legal compliance with state labor regulations.
View the file
Other files
Show all 25
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .