5-AmphCommCntrPh4-WCA.pdf
PDF 3 MB Posted
- Attached to
- AMPHITHEATER / COMMUNITY CENTER - PHASE 4
- Solicitation number
- Not on record
- Issued by
- Northampton County, Pennsylvania
About this file
This is a Worker's Compensation Affidavit form required by Freemansburg Borough, Pennsylvania for the Amphitheater/Community Center - Phase 4 project in Northampton County. The affidavit confirms that bidders and contractors have accepted the provisions of the Worker's Compensation Act of 1915 of the Commonwealth of Pennsylvania and have insured their liability accordingly. Bids for the project will be received online through PennBid until 11:00 AM on Thursday, October 1, 2026. The project involves the design and construction of cast-in-place concrete retaining walls and concrete footings, with the contractor responsible for all supervision, personnel, labor, materials, machinery, equipment, tools, and associated work as indicated in the plans. A mandatory Pre-Bid Meeting is scheduled for 10:00 AM on Thursday, September 17, 2026, at the Freemansburg Borough Building, 600 Monroe Street, Freemansburg, Pennsylvania. Contractors must complete any necessary geotechnical investigations for wall design. No bid may be withdrawn within sixty days of the opening date.
Each bid submission must be accompanied by a Bid Bond in favor of Freemansburg Borough equal to ten percent of the total bid price, subject to conditions outlined in the Instructions to Bidders. Workers employed on this project are subject to federal Davis-Bacon wage rates as promulgated by the U.S. government and available through SAM.gov. All project documents and details are available electronically through PennBid. Freemansburg Borough reserves the right to reject all bids and waive any bidding informalities.
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Text version
Worker's Compensation Affidavit
ACCEPTING PROVISIONS OF THE WORKER'S COMPENSATION ACT
State of _____________ _
SS/FEIN:
; County of _______ _____ _
(Name of Officer, if Corporation) (Title of Officer)·)
_____________________________ ; being duly ( Corporation) sw0rn according to law; deposes and says that he/they/it has/have accepted the provisions of the Worker's Compensation Act of 1915 of the Commonwealth of Pennsylvania, with its supplements amendments, and has/have insured his/their/its liability thereunder in accordance with the terms of said Act with _ ______ __________ Company.
By _ _ _ ______ ~---- Signature of Officer or Agent
SWORN to and subscribe before me this
_____ day of ____ _ ,20 .,.
Notary Public
My Commission Expires:
Insurance ·
AMPHITHEATER / COMMUNITY CENTER - PHASE 4
FREEMANSBURG BOROUGH, NORTHAMPTON COUNTY, PA
(9/2026) 16-1124.044 (AmphCommCntrPh4-WCA.pdf) WPC-1
File details come from the government source that posted it. Updated .