Attachment_9_-_Workers__Comp_Certification.pdf

This document is a Workers' Compensation Certification form required for contract bidders in California. The certification confirms that the undersigned is aware of Section 3700 of the California Labor Code, which mandates that every employer must maintain workers' compensation insurance or be approved for self-insurance before commencing work on the contract. The form serves as Attachment 9 to the Request for Proposal (RFP) and requires the bidder to provide their signature, date, name and title, firm name, and complete street address including city, state, and ZIP code. The RFP number must also be documented on the form.

This certification is a mandatory compliance document that protects both the contracting agency and the bidder by ensuring adequate workers' compensation coverage is in place prior to work commencement. No pricing, set-asides, or contract term information is included in this form, as it functions solely as a verification of insurance compliance requirements. Bidders must complete and submit this certification as part of their proposal package to demonstrate their understanding of and commitment to California's workers' compensation insurance requirements.