Attachment_8_-_Workers__Comp_Certification.pdf
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- Solicitation number
- 0000040582
- Issued by
- Sacramento County, Sacramento City, West Sacramento City, California
About this file
This is a Workers' Compensation Certification form required by the California Arts Council (CAC) for the RFP-26-015 Reasonable Accommodation, Ergonomics and Training Services contract opportunity. The certification document requires contractors to acknowledge compliance with Section 3700 of the California Labor Code, which mandates that every employer maintain workers' compensation insurance or approved self-insurance before commencing work on the contract. The form requires the contractor's signature, date, name, title, firm name, street address, city, state, and ZIP code. The RFP seeks proposals for a three-year single award contract to provide comprehensive professional services supporting the CAC's Reasonable Accommodation, Ergonomics, and Training Services. 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. Proposals must be emailed to Procurement@arts.ca.gov with a deadline of October 22, 2026 by 5 PM, as noted in Attachment 20 of the RFP documentation.
The Workers' Compensation Certification form does not contain pricing information, set-asides, incumbent details, or funding sources, as it serves solely as a compliance verification document. Contractors must complete and submit this certification as part of their proposal package to demonstrate their understanding of and commitment to California's workers' compensation requirements under Public Contract Code sections 10340 to 10345. All bidder questions should be directed to Procurement@arts.ca.gov, with responses posted for all participants to view.
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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: 8 |
| Date: |
| Name and Title Print or Type: |
| Firm Name: |
| Street Address: |
| City: |
| State: |
| ZIP: |
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