Laserfiche WebLink
WORKERS' COMPENSATION INSURANCE CERTIFICATION <br />Pursuant to Section 7-4 of the Standard Specifications, the Contractor certifies as follows: <br />I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured <br />against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of <br />that code, and I will comply with such provisions before commencing the performance of the work of this <br />contract. <br />~r ~ <br />Signed: ~~ Date: <br />(Typed or printed name) <br />Business Address (Street Address, City, State & Zip Code): <br />Business Phone: (~~~ 22 ~ ~~~ <br />Last Revised 11/20/03 Page 5 Agreement <br />Main Library Bookstore Project No. 04-210-18-127 <br />