5-00 45 26 Contractor Compliance.doc
DOC document 60 KB Posted
- Solicitation number
- 25-0232
- Issued by
- Tarrant County, Texas
About this file
This contractor compliance certification document is part of the City of Fort Worth's 2026 Asphalt Resurfacing Contract 3, Project No. 106175, which requires contractors to verify worker's compensation insurance coverage in accordance with Texas Labor Code Section 406.096. The underlying contract involves approximately 65,672 square yards of 2-inch asphalt pavement using Superpave SP-D specifications, 65,672 square yards of 2-inch surface milling, 26,450 square yards of 3-inch asphalt pavement, 26,450 square yards of 11-inch pavement pulverization, 424 tons of Cemlime, and 42 barrier-free ADA ramps.
The document serves as a mandatory certification form that contractors must complete and have notarized, confirming they provide worker's compensation insurance for all employees working on the project and will supply certificates of compliance from their subcontractors. This certification requirement ensures compliance with Texas state labor laws and protects both workers and the City of Fort Worth from potential liability issues during the asphalt resurfacing project execution.
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Other files
| File | Type | Posted |
|---|---|---|
| 10-00 21 13 Instruction to Bidders.docx | DOCX document | |
| 12-Submission Instructions - 25-0232.docx | DOCX document | |
| 9-00 61 19 Maintenance Bond.doc | DOC document | |
| 6-00 52 43 Agreement.doc | DOC document | |
| 1-00 11 13 Invitation to Bidders BONFIRE.doc | DOC document | |
| 11-Project Manual CPN106175 Rev.pdf | ||
| 7-00 61 13 Performance Bond.doc | DOC document | |
| 3-00 45 11 Bidders Prequalifications.doc | DOC document | |
| 8-00 61 14 Payment Bond.doc | DOC document | |
| 2-00 41 00 Bid Proposal Workbook.xlsx | XLSX spreadsheet | |
| 4-00 45 13 Prequalification Application.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. 106175. 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 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
CITY PROJECT NO. 106175
Revised July 1, 2011
File details come from the government source that posted it. Updated .