Attachment_7_-_Individual___Sole_Proprietor.pdf

PDF 32 KB Posted

Attached to
RFP-25-006 Professional Registered Parliamentarian (PRP) Services
Solicitation number
0000038417
Issued by
Sacramento County, Sacramento City, West Sacramento City, California

About this file

This file is an Individual or Sole Proprietorship Exemption Statement for Workers' Compensation Insurance required by the California Arts Council (CAC) in response to RFP-25-006 for Professional Registered Parliamentarian (PRP) Services. The document serves as a certification by individual contractors or sole proprietors that they do not employ any persons in a manner that would subject them to California's Workers' Compensation Laws. Signatories must affirm under penalty of perjury that they will notify the Department of Rehabilitation within ninety (90) days should their business status change and become subject to workers' compensation requirements. The form requires completion with the RFP number, contractor's printed name, signature, and date of submission.

This attachment is a mandatory compliance document for eligible bidder categories, specifically individuals and sole proprietors seeking to contract with the California Arts Council. It is a standard administrative requirement that allows independent contractors and sole proprietors to demonstrate their exempt status from workers' compensation insurance obligations, thereby reducing administrative burden for both the contractor and the contracting agency. The document does not contain pricing information, funding details, or contract term specifications, as it functions solely as a compliance certification within the broader RFP-25-006 procurement process.

View the file

Other files

Show all 13

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

ATTACHMENT ____: Individual or Sole Proprietorship Exempt from Workers’ Compensation Insurance Statement

______ of ______

I certify under penalty of perjury under the laws of the State of California that I do not employ any person in any manner as to become subject to the Workers’ Compensation Laws of California.

I further certify that the Department of Rehabilitation will be notified within ninety (90) days of any changes which results in the business becoming subject to the Workers’ Compensation laws of the State of California.

RFP No.: _____________________

Print Name Date

Signature

Carla Pareja Cross-Out

Compensation Insurance Statement: 7
RFP No:
Print Name:
Date:
of:
undefined:

File details come from the government source that posted it. Updated .