Independent Contractor-Worker Acknowledgement Form (PEDACKN).pdf

This is an Independent Contractor-Worker Acknowledgement Form (PEDACKN) related to the RCI Carpet Project at Ross Correctional Institution in Chillicothe, Ohio. The project involves carpet replacement and renovation services at the state correctional facility located at 16149 State Route 104. The scope of work requires the removal of all existing carpet and rubber base, floor and wall preparation, and installation of new Carbon Copy 54806 carpet squares with matching rubber base and new door transitions as needed. The project covers approximately 2,063 square feet and necessitates the contractor to provide a dumpster positioned outside the prison fence, as well as a trailer and small utility vehicle or golf cart for debris and material transport to the dumpster.

The document serves as an acknowledgement form for independent contractors or workers associated with the project, establishing formal recognition of their engagement or participation. No specific pricing terms, contract duration, award dates, or response deadlines are evident from the form itself, as this document functions primarily as a procedural acknowledgement rather than a comprehensive contract terms document. The form appears to be part of the broader contracting documentation package for Ohio's correctional institution facility management and maintenance operations.