Attachment_8_-_Workers__Comp_Certification.pdf
PDF 76 KB Posted
- Attached to
- RFP-25-016 STRATEGIC PLANNING CONSULTANT
- Solicitation number
- 0000039506
- Issued by
- California
About this file
This is a Workers' Compensation Certification form required for the California Arts Council (CAC) RFP-25-016 Strategic Planning Consultant contract opportunity. The certification document is submitted by bidders to acknowledge compliance with Section 3700 of the California Labor Code, which mandates that every employer maintain workers' compensation insurance or undertake self-insurance before commencing work on the contract. Bidders must complete the form with their signature, date, name, title, firm name, and complete address information, along with the corresponding RFP number.
The certification serves as a mandatory compliance requirement for all bidders responding to the strategic planning consultant solicitation. This form must be included with bid submissions to Procurement@arts.ca.gov and is essential documentation for contract award consideration. The requirement applies uniformly to all eligible bidder categories, including California independent contractors, individuals, sole proprietors, partnerships, certified small businesses, disabled veteran business enterprises, nonprofit organizations, and private for-profit organizations. Bidders must ensure they possess or obtain appropriate workers' compensation coverage prior to contract execution, as this certification verifies their awareness and compliance with California's mandatory insurance provisions.
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Text version
WORKERS’ COMPENSATIONCERTIFICATION
The undersigned in submitting this document hereby certifies the following:
I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with such provisions before commencing the performance of the work of this contract.
Signature Date
Name and Title (Print or Type)
Firm Name
Street Address City State ZIP
RFP No.: _______________
Attachment _______:
| RFP No: |
| undefined: 9 |
| Date: |
| Name and Title Print or Type: |
| Firm Name: |
| Street Address: |
| City: |
| State: |
| ZIP: |
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