Attachment_8_-_Workers__Compensation_Certification.pdf
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- Solicitation number
- 0000038417
- Issued by
- Sacramento County, Sacramento City, West Sacramento City, California
About this file
This is a Workers' Compensation Certification form required for the California Arts Council (CAC) RFP-25-006 Professional Registered Parliamentarian (PRP) Services solicitation in California. The form certifies that the bidder is aware of 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 and submit this certification as part of their proposal package to Procurement@arts.ca.gov, providing their signature, date, name, title, firm name, street address, city, state, and ZIP code.
The certification requirement applies to all eligible bidders responding to the RFP, including 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. This document serves as a compliance verification tool ensuring that contractors meet mandatory California workers' compensation insurance requirements prior to contract execution and performance initiation.
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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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