2-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 43 KB Posted
- Solicitation number
- 26-0286
- Issued by
- Tarrant County, Texas
About this file
This is a Contractor Compliance with Worker's Compensation Law certification document for the City of Fort Worth's PW 2027 Hot In Place Recycling Contract 1, identified as City Project No. 106793. The document requires contractors to certify compliance with Texas Labor Code Section 406.096(a) by providing worker's compensation insurance coverage for all employees assigned to the project. The major work scope includes approximately 71,957 square yards of hot in-place recycling, surface milling, and 1-inch asphalt pavement placement (Type SP-D, PG 70-22 Superpave); 1,385 cubic yards of asphalt pavement base repair; 843 cubic yards of cement-treated flexible base; concrete curb and gutter replacement (690 linear feet); concrete driveway and sidewalk replacement (1,091 square feet each); three ADA curb ramp replacements; and 53,317 linear feet of pavement marking.
Contractors must also provide certificates of compliance from all subcontractors demonstrating their worker's compensation coverage in accordance with Texas Labor Code Section 406.096(b). The certification document requires the contractor's authorized representative to execute the form and have it notarized before a Notary Public in Tarrant County, Texas. This compliance requirement is a mandatory standard construction specification for the project, with the document revised as of July 1, 2011.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 7-CPN 106793 Project Manual.pdf | ||
| 10-106793 Addendum No. 1.pdf | ||
| 8-106793 Prebid Sign-In Sheet.pdf | ||
| 6-City Project No. 106793.xlsx | XLSX spreadsheet | |
| 9-106793 Prebid Meeting.pdf | ||
| 1-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 3-00 45 13 Prequalification Application.docx | DOCX document | |
| 5-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 4-00 45 11 Bidders Prequalifications.doc | DOC document | |
| 11-Submission Instructions - 26-0286 (rev. 091426).docx | DOCX document |
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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. 106793. 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
2027 HOT IN PLACE RECYCLING CONTRACT 1
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City Project No. 106793 Revised July 1, 2011
File details come from the government source that posted it. Updated .