8-Acknowledgement 1 Workers Compensation.pdf

This is a Worker's Compensation Acknowledgement form issued by Chester City Hall in Chester, Pennsylvania, in connection with the City of Chester's Lead Safe and Healthy Homes Program. The form requires bidders to acknowledge their awareness of Pennsylvania Labor Code provisions mandating that every employer maintain workers' compensation insurance or undertake self-insurance in accordance with state law. Bidders must certify their compliance with these requirements before commencing performance of contract work. The form requires completion of bidder company name, contact name, title, signature, and date fields.

The acknowledgement form is a prerequisite document for contractors seeking inclusion in a prequalified pool to provide lead remediation services for approximately 120 residential properties over a three-year period under the City's Lead Safe and Healthy Homes Program. The program is funded primarily through a Lead Hazard Reduction Grant awarded by the U.S. Department of Housing and Urban Development (HUD) and is administered by the City of Chester's Bureau of Health. Qualified and certified lead abatement contractors must complete and submit this acknowledgement as part of their bid documentation to demonstrate compliance with state workers' compensation requirements.