5-00 45 26 Contractor Compliance with Workers Compensation Law.doc
DOC document 43 KB Posted
- Solicitation number
- 26-0033
- 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. 106290 - 2026 Asphalt Resurfacing Contract 6. The project involves comprehensive road resurfacing work, including approximately 800 tons of cemlime, 13,000 square yards of 2-inch surface milling, 13,000 square yards of 2-inch Asphalt Pavement Superpave SP-D, 50,200 square yards of 11-inch pulverization, and 50,200 square yards of 3-inch Asphalt Pavement Superpave SP-D.
The certification requires contractors to provide worker's compensation insurance coverage for all employees and to submit subcontractor certificates of compliance with worker's compensation coverage. The document includes a notarization section for official verification and is part of the standard construction specification documents for the City of Fort Worth. While specific pricing details are not included in this document, it serves as a critical compliance requirement for contractors bidding on or performing work for this municipal infrastructure improvement project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-00 11 13 Invitation to Bidders.docx | DOCX document | |
| 3-00 45 13 Prequalification Application.pdf | ||
| 2-City Project No. 106290.xlsx | XLSX spreadsheet | |
| 6-00 45 11 Bidders Prequalifications.pdf | ||
| 7-CPN106290 Project Manual.pdf | ||
| 4-Bid Documents Package Folder Contents Checklist.doc | DOC document | |
| 8-Submission Instructions - 26-0033.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. 106290. 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 6
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
City Project No. 106290 Revised July 1, 2011
File details come from the government source that posted it. Updated .