3-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 43 KB Posted
- Solicitation number
- 26-0302
- 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, Texas, related to Project No. 106795, the PW 2027 Concrete Restoration Contract 4. The project involves approximately 13,000 square yards of concrete panel replacement, 1,000 cubic yards of flexible base Type A GR-2, and 4,100 square yards of geogrid base reinforcement Type 2. The document requires the contractor 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 contractor must also provide certificates of compliance from all subcontractors as required under Texas Labor Code Section 406.096(b). The certification must be notarized before a notary public in the State of Texas, with the notarization dated and executed by the notary.
No pricing terms, set asides, response deadlines, site visit information, bidder's conferences, award dates, contract term details, or renewal options are specified in this compliance document. The document serves solely as a certification and attestation requirement for contractor eligibility and does not address funding sources, amounts, or other financial considerations related to the concrete restoration contract.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 7-CPN 106795 Pre-Bid Meeting Sign in Sheet.xlsx | XLSX spreadsheet | |
| 5-CPN106795 Project Manual.pdf | ||
| 6-Submission Instructions - 26-0302 (rev. 090426).docx | DOCX document | |
| 8-CPN106795 Pre-Bid Conference.pptx | PPTX presentation | |
| 4-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 2-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 1-2027 Concrete Restoration Contract 4.xlsx | XLSX spreadsheet |
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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. 106795. 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 Concrete Restoration Contract 4
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City Project No. 106795 Revised July 1, 2011
File details come from the government source that posted it. Updated .