3-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 43 KB Posted
- Solicitation number
- 26-0281
- 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 2027 Asphalt Resurfacing Contract (City Project No. 106864). 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 project scope includes approximately 67,472 square yards of 11-inch pavement pulverization, 67,472 square yards of 3-inch asphalt pavement (Superpave SP-D), 1,080 tons of cement-lime at 32 lbs/sy, 5,162 linear feet of concrete curb and gutter removal and replacement, 332 square yards of concrete valley gutter installation, 4,616 square feet of concrete driveway removal and replacement, and 18 concrete ADA curb ramp removals and replacements.
Under Texas Labor Code Section 406.096(b), contractors must provide the City with certificates of compliance demonstrating that all subcontractors maintain appropriate worker's compensation coverage. The certification document requires the contractor to provide company information, execute the document with a signature, and have the execution notarized before a notary public in Tarrant County, Texas. This compliance requirement is a mandatory prerequisite for contract award, and all contractors bidding on City Project No. 106864 must submit the completed and notarized certification as part of their bid package.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 8-106864 Prebid Sign-In Sheet.pdf | ||
| 11-Submission Instructions - 26-0281 (rev. 090826).docx | DOCX document | |
| 9-106864 Prebid Meeting.pdf | ||
| 5-00 45 11 Bidders Prequalifications.doc | DOC document | |
| 2-City Project No. 106864.xlsx | XLSX spreadsheet | |
| 1-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 6-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 10-Addendum No. 1 106864.pdf | ||
| 4-00 45 13 Prequalification Application.docx | DOCX document | |
| 7-CPN 106864 Project Manual.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. 106864. 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 ASPHALT RESURFACING CONTRACT 4
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City Project No. 106864 Revised July 1, 2011
File details come from the government source that posted it. Updated .