ATTACHMENT 8- WORKERS_ COMPENSATION CERTIFICATION.pdf
PDF 41 KB Posted
- Solicitation number
- 0000040415
- Issued by
- California
About this file
This is a Workers' Compensation Certification attachment required for submission with a proposal to a California state or local government entity. The certification form mandates that bidders acknowledge their awareness of California Labor Code Section 3700, which requires all employers to maintain workers' compensation insurance or establish a self-insurance program prior to commencing work under the contract. The form requires completion and submission by the bidder's authorized representative or corporate officer, including the bidder/firm name, printed name and title of the authorized representative, signature, and date of certification.
No additional information regarding pricing, contract term, project specifics, or other substantive contract details is provided in this attachment. This document serves solely as a compliance verification mechanism to ensure bidders meet mandatory workers' compensation insurance requirements under California law before contract performance begins.
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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:
ATTACHMENT 8: WORKERS' COMPENSATION CERTIFICATION
File details come from the government source that posted it. Updated .