5-Attachment VI-B - Workers Compensation Insurance (Subcontractor).pdf

This is a Workers Compensation Insurance Certification form required by the City of Buda, Texas for subcontractors performing work on the Garrison Park Construction project. The form implements requirements under Texas Labor Code 406.096, mandating that all subcontractors involved in the project must provide written certification of workers compensation insurance coverage to the City of Buda prior to commencing work. The project encompasses the construction of a new park with a comprehensive scope that includes site grading, two parking lots, utility installation (water, sewer, electric), entrance monument signage, concrete and decomposed granite trails, restroom facilities, overlooks, canopy walks, nature-play areas, water access points, boat launch, stormwater features, custom signage, and landscaping. Subcontractors must complete the certification form by providing their name and having an authorized representative sign and date the document, with one copy required for each subcontractor participating in the project.

The form serves as a compliance mechanism to ensure adequate insurance protection for workers on the project site. No specific pricing, insurance amounts, or coverage terms are detailed in the certification document itself, as it functions solely as an attestation that subcontractors possess the required workers compensation insurance as mandated by state law. Submission of this certification is a prerequisite to subcontractor participation in the project and must be provided to the City of Buda prior to work commencement.