4-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 43 KB Posted
- Solicitation number
- 26-0287
- 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 City Project No. 106796, a 2027 Asphalt Resurfacing Contract 5. 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 project involves approximately 250 tons of cement lime, 15,500 square yards of 11-inch pulverization, 15,500 square yards of 3-inch asphalt pavement, 49,000 square yards of 4-inch surface milling, and 49,000 square yards of 4-inch asphalt pavement. The certification must be executed with the contractor's signature and company information, followed by notarization before a Texas notary public in Tarrant County.
The contractor is also required to provide certificates of compliance from all subcontractors confirming their worker's compensation coverage, as mandated by Texas Labor Code Section 406.096(b). This compliance documentation serves as a prerequisite for contract execution and demonstrates the contractor's adherence to state worker's compensation insurance requirements. The document was revised as of July 1, 2011, and represents a standard construction specification requirement for the City of Fort Worth.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-00 45 11 Bidders Prequalifications.pdf | ||
| 5-00 45 13 Prequalification Application.docx | DOCX document | |
| 2-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 3-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 9-CPN 106796 2027 Asphalt Resurfacing Contract 5 - Addendum No. 1.pdf | ||
| 8-City Project No. 106796 - Addendum No. 1.xlsx | XLSX spreadsheet | |
| 7-CPN 106796 Pre-Bid Meeting Sign in Sheet.xlsx | XLSX spreadsheet | |
| 6-CPN106796 Project Manual.pdf | ||
| 10-Submission Instructions - 26-0286 (rev. 090426).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. 106796. 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 5
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City project No. 106796 Revised July 1, 2011
File details come from the government source that posted it. Updated .