5-00 45 26 Contractor Compliance with Workers Compensation Law.pdf

This is a contractor compliance certification document issued by the City of Fort Worth for City Project No. 106104, the Cibolo Hills Parkway project in Texas. The document requires contractors to certify compliance with Texas Labor Code Section 406.096(a), affirming that they provide worker's compensation insurance coverage for all employees working on the project. Contractors must also commit to obtaining and providing certificates of compliance from all subcontractors, as mandated by Texas Labor Code Section 406.096(b). The project involves significant infrastructure improvements including approximately 1,569 linear feet of 16-inch PVC waterline, 348 linear feet of 16-inch DIP waterline with 30-inch steel casing, 1,069 to 1,010 linear feet of reinforced concrete pipe and storm box culverts with associated drainage appurtenances, 6,369 square yards of 10-inch concrete pavement, 24,287 square feet of concrete sidewalk, and 22 roadway lighting assemblies with LED fixtures and electrical components.

The document serves as a notarized certification form requiring the contractor's authorized representative to attest under oath before a notary public that worker's compensation insurance requirements have been met. This certification must be executed in Tarrant County, Texas, and represents a mandatory compliance requirement for participation in City Project No. 106104. No pricing information, contract term, or financial details are specified in this compliance document, as it functions solely as a prerequisite certification component of the broader contract opportunity.