4-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 59 KB Posted
- Solicitation number
- 25-0224
- Issued by
- Tarrant County, Texas
About this file
This document is a Contractor Compliance with Worker's Compensation Law certification for the City of Fort Worth, Texas, specifically related to City Project No. 106169 for a Hot In Place Recycling Contract. The project involves comprehensive road infrastructure improvements, including approximately 93,274 square yards of 1" asphalt pavement recycling, surface milling, and related roadway enhancements. The scope of work encompasses pavement base repairs, cement-treated flexible base installation, concrete curb and gutter replacements, driveway and sidewalk repairs, ADA curb ramp replacements, and extensive pavement marking.
The certification document requires contractors to provide worker's compensation insurance coverage for all employees and mandates that subcontractors also demonstrate compliance with worker's compensation requirements. While specific pricing details are not included in this document, the project appears to be a municipal infrastructure improvement initiative funded by the City of Fort Worth. The document includes a notarization section that allows for official certification of the contractor's compliance with Texas Labor Code Section 406.096, ensuring legal and regulatory adherence to worker's compensation regulations for this public works project.
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Other files
| File | Type | Posted |
|---|---|---|
| 7-City Project No. 106169.xlsx | XLSX spreadsheet | |
| 8-Submission Instructions - 25-0224.docx | DOCX document | |
| 1-00 11 13 Invitation to Bidders BONFIRE.docx | DOCX document | |
| 2-00 45 11 Bidders Prequalifications.doc | DOC document | |
| 5-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 3-00 45 13 Prequalification Application.docx | DOCX document | |
| 6-106169 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. 106169. 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 HOT IN PLACE RECYCLING CONTRACT 1
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City Project No. 106169 Revised July 1, 2011
File details come from the government source that posted it. Updated .