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WORKERS' COMPEN SAT]ONIN S URANCE CERTIFICATION <br /> Pursuant to Section 7-3 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 <br /> of that code, and I will comply with such provisions before commencing the performance of the work of <br /> this contract. <br /> August 10, 2017 <br /> Signed: ------------------ Date: <br /> Richard B. Gates, President <br /> (Typed or Printed Name) <br /> Business Address(Street Address, City, State&Zip Code): <br /> 11555 Dublin Boulevard <br /> - - EU-N...-. . ........... <br /> Dublin,C:A -91-568 <br /> Business Phone: (925-)_829--9-22Q <br /> Last Revised:06/01/16 Page 8 Agreement <br /> Annual Overlay/Rehabilitation 2016-17 Phase 1 Project No.2017.0050 <br />