Laserfiche WebLink
CITY OF SANTA ANA <br />PROJECT NO. 2720A <br />PROPOSAL AND CONTRACT AGREEMENT <br />WORKERS' COMPENSATION INSURANCE CERTIFICATION <br />As required by California Labor Code Section 1860 and 1861, the Contractor <br />certifies as follows: <br />I am aware of the provisions of Section 3700 of the Labor Code, which requires <br />every employer to be insured against liability for worker's compensation or to <br />undertake self-insurance in accordance with the provisions of the Code, and I will <br />comply with such provisions before commencing the performance of the work of <br />this contract. <br />If I, as the Contractor, now or at any time during the course of this agreement, <br />qualify as an employer under California Labor Code Section 3300, unless the <br />hired employee(s) is (are) persons excluded by said Labor Code, I shall furnish <br />the City of Santa Ana with an insurance certificate from my workers' <br />compensation insurance carrier certifying that I carry such insurance and that the <br />policy shall not be canceled nor the coverage reduced except upon thirty (30) <br />days prior written notice to the City of Santa Ana. <br />Signed <br />Title Director Commercial Relocations <br />Firm Kira Office Services <br />Date June 18, 1999 <br />BP9of14 <br />To be included in Bid Proposal <br />