Laserfiche WebLink
WORKERS' COMPENSATION INSURANCE STATEMENT <br />I, the undersigned and authorized agent for the Contractor, am aware of the provisions of <br />Section 3700 of the Labor Code which requires every employer to be insured against liability <br />for workers' 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 <br />work under Contract No. 23-6827-2960. <br />By: <br />JDC, Inc. <br />Name of Contractor <br />Signat ire of Authorized Agent <br />Jim De Armond, President <br />Signatory's Title <br />689334 A <br />Contractor's License No. <br />