4-00 45 26 Contractor Compliance.doc
DOC document 60 KB Posted
- Solicitation number
- 25-0256
- Issued by
- Tarrant County, Fort Worth City, Texas
About this file
This document is a Contractor Compliance form for worker's compensation insurance for the City of Fort Worth, specifically related to City Project No. 106176/106177 for a Concrete Restoration Contract. The project involves substantial concrete infrastructure work, including approximately 7,950 square yards of 9" concrete pavement, 2,000 square yards of 7" concrete pavement, 2,750 cubic yards of flex base, and 12,450 square yards of geogrid installation. The document requires contractors to certify that they provide worker's compensation insurance coverage for all employees working on the project and that they will obtain similar certification from subcontractors.
The compliance form is a standard construction specification document prepared by the City of Fort Worth in Texas, dated July 1, 2011. It includes a notarized certification section where contractors must sign and acknowledge their compliance with Texas Labor Code Section 406.096, specifically regarding worker's compensation insurance. While the document does not specify exact pricing, funding sources, or contract term lengths, it is part of a formal municipal infrastructure improvement project focused on concrete restoration and road infrastructure enhancement in the Fort Worth area.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-00 41 00 Bid Proposal Workbook.xlsx | XLSX spreadsheet | |
| 6-00 21 13 Instruction to Bidders (1).docx | DOCX document | |
| 5-00 52 43 Agreement.docx | DOCX document | |
| 7-00 61 19 Maintenance Bond.doc | DOC document | |
| 2-00 45 41 Small Business Goal (1).pdf | ||
| 10-Submission Instructions - 25-0256.docx | DOCX document | |
| 8-00 61 14 Payment Bond.doc | DOC document | |
| 9-Project Manual CPN 106177.pdf | ||
| 1-00 11 13 Invitation to Bidders BONFIRE.doc | DOC 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. 106176. 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 CONCRETE RESTORATION CONTRACT 1
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
CITY PROJECT NO. 106177
Revised July 1, 2011
File details come from the government source that posted it. Updated .