Laserfiche WebLink
RFP NO.: 17-075 <br />WORKERS' COMPENSATION INS_URAN", CERTiIi'ICATIO <br />As required by California Labor Code Section 1861 and 1861, the Contractor certifies as follows: <br />I am aware of the provisions of Section 3700 of Hie Labor Code, whiob requires every employer to be <br />Insured against liability for worker's compensation or to undertake self-insurance in accordance with the <br />provisions of the Coda,,Vd I will comply wide such provisions before commencing the pertbnnance of <br />the work of this cont, j ' <br />Signed; <br />Title; <br />Firm; Siemens IndusIV, Pc Intelligent Traffic Systems <br />Date; 8/14/2017 <br />City of Santa Ana RFP 17-075 <br />Page A4.6 <br />55A-394 <br />