ATTACHMENT 8- WORKERS_ COMPENSATION CERTIFICATION.pdf

PDF 43 KB Posted

Attached to
Governor's Office of Emergency Services, 9-1-1 Call Processing Equipment RFP 26-16743 Pre-Solicitation
Solicitation number
0000038424
Issued by
California

About this file

This is a Workers' Compensation Certification form issued by the State of California Governor's Office of Emergency Services for RFP 26-16743. The form must be completed and submitted by bidders as part of their proposal response, with a submission deadline of April 20, 2026. The certification requires bidders to acknowledge compliance with Section 3700 of the California Labor Code, which mandates that all employers maintain workers' compensation insurance or self-insurance coverage prior to commencing contract work.

The form requires completion by the bidder's authorized representative or corporate officer, with fields for the bidder's firm name, the authorized representative's printed name, title or role, signature, and submission date. No pricing terms, set-asides, incumbents, or funding information is contained within this certification document, as it serves solely as a compliance verification requirement for contract eligibility.

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Text version

ATTACHMENT 8: WORKERS' COMPENSATION CERTIFICATION

The Bidder must complete and submit this form with its proposal.

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 require 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.

The Bidder's Authorized Representative or Corporate Officer Bidder/Firm Name:

Printed Name of Authorized Representative:

Title/Role:

Signature:

Date:

State of California Governor's Office of Emergency Services

RFP 26-16743

Bidder Response

April 20, 2026

ATTACHMENT 8: WORKERS' COMPENSATION CERTIFICATION

File details come from the government source that posted it. Updated .