7-Acknowledgements 3 Workers Compensation.pdf
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- Solicitation number
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- Delaware County, Pennsylvania
About this file
This document is a Worker's Compensation Acknowledgement form from Chester City Hall, located at 1 East 4th Street in Chester, Pennsylvania. The form requires a bidding company to confirm awareness and compliance with Pennsylvania Labor Code provisions regarding workers' compensation insurance or self-insurance before commencing work on a contract. The form provides space for a bidder to record their company name, contact information, title, signature, and the date of signing.
The document does not contain specific details about a contract, project scope, pricing, or funding. It is a standard legal acknowledgement form that bidders must complete to demonstrate their understanding of and commitment to maintaining appropriate workers' compensation coverage as required by Pennsylvania state law. The form appears to be a mandatory submission for potential contractors bidding on city projects.
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Text version
Chester City Hall, Municipal Building, 1 East 4th Street, Chester, Pennsylvania, 19013
WORKER’S COMPENSATION ACKNOWLEDGEMENT
I am aware of the provisions of Pennsylvania Labor Code which requires every employer to be insured against liability for Workers Compensation or to undertake self-insurance in accordance with the provisions of that Code, and I shall comply with such provisions before commencing the performance of the Work of this Contract.
Bidder Company Name:
Bidder Company Contact Name:
Title:
Signature:
Today’s Date:
File details come from the government source that posted it. Updated .