Contractor's_Certificate_Regarding_Workers'_Compensation.pdf
PDF 691 KB Posted
- Attached to
- Hayward Rides Program Support
- Solicitation number
- 25-056
- Issued by
- Alameda County, Hayward City, California
About this file
The document is a Contractor's Certificate Regarding Worker's Compensation form for the City of Hayward's Hayward Rides Program Support procurement (Bid Number 25-056). The certificate is required to be completed, executed, and submitted with the bid form, demonstrating compliance with California Labor Code Section 3700, which mandates that employers secure worker's compensation insurance or obtain a self-insurance certificate from the Director of Industrial Relations before commencing contract work.
The form requires contractors to affirm their understanding of Labor Code provisions by certifying they will either be insured against worker's compensation liability through authorized insurers or secure a self-insurance certificate. The document emphasizes that the certificate must be signed and filed with the awarding body (City of Hayward) prior to performing any contract work, ensuring legal compliance and protection for employees in the event of workplace injuries or compensation claims.
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Text version
*THIS DOCUMENT MUST BE COMPLETED, EXECUTED AND SUBMITTED WITH THE BID FORM*
CONTRACTOR’S CERTIFICATE
REGARDING WORKER’S COMPENSATION
LABOR CODE SECTION 3700
“Every employer except the State and all political subdivisions or institutions thereof, shall secure the payment of compensation in one or more of the following ways:
(a) By being insured against liability to pay compensation in one or more insurers duly authorized to write compensation insurance in this State.
(b) By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing proof satisfactory to the City of Industrial Relations of ability to self-insure and to pay any compensation that may become due to this employees.’
I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker’s compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of this contract.
SIGNATURE: ______________________________
Print Name: ______________________________
Date: ______________________________
(In accordance with Article 5 [commencing at Section 1860], Chapter I, Part 7, Division 2 of the Labor Code, the above certificate must signed and filed with the awarding body prior to performing any work under this contract.)
File details come from the government source that posted it. Updated .