Laserfiche WebLink
CITYOFSAN'fAANA <br />PROIECf OBfi028 FAIRVIEW TRIANGLE HABITAT RESTORATION <br />PROPOSAL AND CONTRACT AGREEMENT <br />WORKERS' COMPENSATION INSURANCE CERTIFICATION <br />As required by California hfror CodeSeclion 1660 and 1861, IheComramor certifies as follows: <br />I am aware of the provisions of Section 5700 of the Labor Code, which requires every employer to be <br />insured against liability for worker's compensation or to underlakeself-Insurance in accordance wish the <br />prouisians of theCode, and I will comply wi[h such provisioos beforecommencing Iheperformance of <br />the work of this comraGIf I, as the Comractor, now or at any lime during the nurse of this agreement, qualify as an employer <br />under (aalifornia Labor Code Sermon 3700, unless the hired employee(s) is (are) persons excluded by <br />said Lshor Cade, I shall Pomish IheCily of Santa Ana wish an insuraocecerlificate Gom my workers' <br />compensation insurance carrier certify'mg Thal I carry suoh insurance and that the policy shall not be <br />ceneNed nor the coverage reduced eacepl upon Ihiriy (30) days prior written notice m the Ci(y of Santa <br />Ana. <br />Signed <br />Tide 6PSs ,n <br />Firm ?C? CI) ?kC? <br />Date ?I7 ? 1 <br />TO BEINCLODED IN BID PACKAGE <br />RP 9 of JI