Attachment_9_-_Workers__Compensation_Certification.pdf
PDF 57 KB Posted
- Solicitation number
- 0000034798
- Issued by
- Sacramento County, Sacramento City, West Sacramento City, California
About this file
This document is a Workers' Compensation Certification form for Request for Proposal (RFP) No. RFP-24-004, which requires potential bidders to acknowledge and certify compliance with Section 3700 of the California Labor Code. The form mandates that every employer must be insured against workers' compensation liability or undertake self-insurance before beginning work on the contract.
The certification form is a standard legal document with blank fields for a vendor's signature, date, name and title, firm name, and street address. It serves as an official attestation that the bidding company understands and will comply with California state labor regulations regarding workers' compensation insurance, which is a standard requirement for participating in state and local government contract opportunities.
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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: RFP-24-004 |
| undefined: 9 |
| Date: |
| Name and Title Print or Type: |
| Firm Name: |
| Street Address: |
| City: |
| State: |
| ZIP: |
File details come from the government source that posted it. Updated .