Attachment_7-_Individual___Sole_Proprietor.pdf

This is a Workers' Compensation Insurance Exemption Statement attachment for RFP-25-017 issued by the California Arts Council. The document serves as a certification form for individual contractors or sole proprietors seeking to demonstrate exemption from California's Workers' Compensation Insurance requirements. The statement requires the contractor to certify under penalty of perjury that they do not employ any persons in a manner that would subject their business to California's Workers' Compensation Laws. Additionally, the contractor must commit to notifying the Department of Rehabilitation within ninety (90) days of any changes that would result in the business becoming subject to these workers' compensation requirements. The form includes spaces for the contractor's printed name, signature, date, and RFP number for record-keeping purposes.

This attachment is a mandatory compliance document for individuals or sole proprietors bidding on the California Arts Council's RFP-25-017 for Panelist Technical Assistance, a contract not exceeding $200,000 with a twelve-month term. Contractors must complete and submit this certification as part of their bid package to Procurement@arts.ca.gov to establish their eligibility status regarding workers' compensation insurance obligations in California. The form ensures that the state has proper documentation of the contractor's employment status and commitment to compliance with applicable state labor laws.