ATTACHMENT 8- WORKERS_ COMPENSATION CERTIFICATION.pdf

PDF 43 KB Posted

Attached to
Governor's Office of Emergency Services (Cal OES), 9-1-1 Call Processing Equipment, RFP 26-16743 Solicitation
Solicitation number
0000039071
Issued by
Sacramento County, San Francisco City, California

About this file

Written by GovTribe AI ·

This is a Workers' Compensation Certification form issued by the State of California Governor's Office of Emergency Services for RFP 26-16743, with a bidder response deadline of April 27, 2026. The certification form must be completed and submitted by all bidders as part of their proposal submission. The form requires bidders to acknowledge their awareness of Section 3700 of the California Labor Code, which mandates that every employer must maintain workers' compensation insurance or undertake self-insurance in accordance with state law before commencing work on the contract.

The form requires the bidder's authorized representative or corporate officer to provide their firm name, printed name, title/role, signature, and date of certification. This document serves as a compliance verification mechanism to ensure that bidders are aware of and acknowledge their obligations under California labor law regarding workers' compensation coverage prior to contract performance.

View the file

Other files

File Type Posted
ATTACHMENT 4- COVER LETTER FORM.pdf PDF
eVAQ-Manual_for_Vendors.pdf PDF
ATTACHMENT 11- ADVANCE NOTIFICATION FOR CUSTOMER PREMISE EQUIPMENT (CPE) FUNDING.pdf PDF
ATTACHMENT 5- RESPONSE TO ADMINISTRATIVE REQUIREMENTS.pdf PDF
ATTACHMENT 13- CAL OES _ PUBLIC SAFETY COMMISSION (TD 288).pdf PDF
EXHIBIT A- STATEMENT OF WORK.pdf PDF
EXHIBIT B- TECHNICAL REQUIREMENTS.pdf PDF
ATTACHMENT_12_BIDDER_QUALIFICATIONS_MATRIX_042726.xlsx XLSX spreadsheet
ATTACHMENT 2- INTENT TO BID FORM.pdf PDF
ATTACHMENT 17- CONTRACTOR_S LICENSE INFORMATION (INSTALLATION SERVICES ONLY).pdf PDF
9-1-1 Call Processing Equipment (CPE)_1.pdf PDF
ATTACHMENT 7- BIDDER DECLARATION GSPD 05-105.pdf PDF
ATTACHMENT 9- COMMERCIALLY USEFUL FUNCTION (CUF) CERTIFICATION.pdf PDF
EXHIBIT_B_TECHNICAL_REQUIREMENTS_042726.docx DOCX document
ATTACHMENT 16- SAMPLE SOW TEMPLATE.pdf PDF
ATTACHMENT 10- CONFIDENTIALITY STATEMENT FORM (POST AWARD).pdf PDF
9-1-1 Call Processing Equipment (CPE).pdf PDF
CDT OSTP Request For Proposal.pdf PDF
ATTACHMENT 12- BIDDER QUALIFICATIONS MATRIX.pdf PDF
EXHIBIT_C_New_On_Prem_cost_workbook_042726.xlsx XLSX spreadsheet
CDT OSTP Request For Proposal_1.pdf PDF
EXHIBIT C- COST WORKBOOKS.pdf PDF
ATTACHMENT 1- TEMPLATE FOR QUESTION SUBMITTAL_REQUEST FOR CHANGES.pdf PDF
ATTACHMENT 6- CONFIDENTIALITY STATEMENT FORM.pdf PDF
ATTACHMENT 3- FOLLOW-ON CONTRACT DISCLOSURE FORM.pdf PDF
EXHIBIT_C_New_Cloud_cost_workbook_042726.xlsx XLSX spreadsheet
ATTACHMENT 14- CPE SERVICE INVOICE TEMPLATE INSTRUCTIONS.pdf PDF
ATTACHMENT 15- CPE SERVICE INVOICE TEMPLATE.pdf PDF
Show all 28

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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 27, 2026

ATTACHMENT 8: WORKERS' COMPENSATION CERTIFICATION

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