Attachment_7-_Individual___Sole_Proprietor.pdf

PDF 40 KB Posted

Attached to
RFP-26-015 Reasonable Accommodation, Ergonomics and Training Services
Solicitation number
0000040582
Issued by
Sacramento County, Sacramento City, West Sacramento City, California

About this file

This is an Individual or Sole Proprietorship Exemption Statement attachment to Request for Proposal RFP-26-015 issued by the California Arts Council (CAC). The RFP seeks qualified contractors to provide comprehensive professional services in reasonable accommodation, ergonomics, and training services to support the CAC. The contract will be awarded to a single vendor for a three-year term. Eligible respondents include California independent contractors, individuals, sole proprietors, partnerships, California Certified Small Businesses, Disabled Veteran Business Enterprises, 501(c)(3) organizations registered in California, private for-profit organizations, and organizations with joint powers agreements based in California. The deadline for bid submission is October 22, 2026 by 5 PM, with all bids to be emailed to Procurement@arts.ca.gov. Additional key action dates are available in Attachment 20 of the RFP.

The attachment itself is a certification form for individual contractors and sole proprietors to declare their exemption from California Workers' Compensation Insurance requirements. By signing this document, individuals certify under penalty of perjury that they do not employ any person in a manner subject to California Workers' Compensation Laws and agree to notify the Department of Rehabilitation within 90 days should their business status change to become subject to these requirements. This form must be completed and submitted as part of the proposal package for individuals or sole proprietors bidding on this opportunity.

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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 .