2-00 45 26 Contractor Compliance with Workers Compensation Law.doc

DOC document 43 KB Posted

Attached to
PW 2026 Asphalt Resurfacing Contract 6 (CPN106290)
Solicitation number
25-0255
Issued by
Tarrant County, Frankston Town, Texas

About this file

This document is a Contractor Compliance with Worker's Compensation Law certification for the City of Fort Worth, specifically related to City Project No. 106290, a 2026 Asphalt Resurfacing Contract 6. The project involves comprehensive road resurfacing work, including approximately 800 tons of cement lime, 13,000 square yards of 2-inch surface milling, 13,000 square yards of 2-inch Asphalt Pavement Superpave SP-D, 50,200 square yards of 11-inch pulverization, and 50,200 square yards of 3-inch Asphalt Pavement Superpave SP-D.

The document requires contractors to certify that they provide worker's compensation insurance coverage for all employees working on the project, in compliance with Texas Labor Code Section 406.096. While specific pricing details are not included in this document, the certification form indicates that contractors must submit proof of worker's compensation coverage for themselves and their subcontractors. The project is located in Tarrant County, Texas, and requires a notarized signature from the contractor affirming their compliance with state labor regulations.

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Other files

File Type Posted
4-00 11 13 Invitation to Bidders.docx DOCX document
3-00 45 11 Bidders Prequalifications.pdf PDF
7-Submission Instructions - 25-0255.docx DOCX document
5-Bid Documents Package Folder Contents Checklist.doc DOC document
1-City Project No. 106290.xlsx XLSX spreadsheet
6-CPN106290 Project Manual.pdf PDF

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Text version

00 45 26 - 1

CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW

SECTION 00 45 26

CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW

Pursuant to Texas Labor Code Section 406.096(a), as amended, Contractor certifies that it provides worker’s compensation insurance coverage for all of its employees employed on City Project No. 106290. Contractor further certifies that, pursuant to Texas Labor Code, Section 406.096(b), as amended, it will provide to City its subcontractor’s certificates of compliance with worker’s compensation coverage.

CONTRACTOR:

_____________________________________ By: ___________________________________ Company

(Please Print) _____________________________________ Signature: ______________________________

Address

Title: __________________________________

City/State/Zip

(Please Print)

THE STATE OF TEXAS

COUNTY OF TARRANT

BEFORE ME, the undersigned authority, on this day personally appeared

___________________________________, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same as the act and deed of ____________________________________ for the purposes and consideration therein expressed and in the capacity therein stated.

GIVEN UNDER MY HAND AND SEAL OF OFFICE this ____________day of

_______________________, 20__.

Notary Public in and for the State of Texas

END OF SECTION

CITY OF FORT WORTH

2026 Asphalt Resurfacing Contract 6

STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS

City Project No. 106290 Revised July 1, 2011

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