Attachment_8_-_Workers__Compensation_Certification.pdf
PDF 71 KB Posted
- Attached to
- RFP-25-002: 50th Anniversary Event Producer
- Solicitation number
- 0000036746
About this file
This document is a Workers' Compensation Certification form, likely associated with a Request for Proposal (RFP) process in California. The form requires the prospective contractor to acknowledge and certify awareness of Section 3700 of the California Labor Code, which mandates that every employer must be insured against workers' compensation liability or undertake self-insurance before commencing work on a contract.
The form is a standard compliance document that must be completed and signed by a representative of the bidding firm, providing their signature, name, title, firm name, and business address. While the specific RFP number is not filled in, the document is designed to ensure that any contractor engaging in work understands and complies with California's legal requirements for workers' compensation insurance, serving as a protective measure for both workers and employers.
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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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