Common use of COMPENSATION CERTIFICATION Clause in Contracts

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement.

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part Consultant scope of this Agreement.work includes the following services:

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement.

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal - Scope of work is not made part the Upgrade and support of this Agreement.the District's telephone systems (calling, call center, voicemail, emergency response).  Copy current telephone system to new platform  Migrating to the upgraded system

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal dated January 20, 2014, is not made part of this Agreement.. Exhibit A serves as an outline of services the Security Consultant will provide the District under this Independent Consultant agreement. Services include:

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. [IF A CONSULTANT PROVIDES AN ACCEPTABLE DESCRIPTION OF SERVICES AS PART OF A PROPOSAL, THAT DESCRIPTION OF SERVICES CAN BE ATTACHED WITHOUT ANY TERMS, CONDITIONS, LIMITATIONS, ETC., FROM THAT PROPOSAL.]

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part Consultant scope of this Agreement.work includes the following services:

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. [IF A CONSULTANT PROVIDES AN ACCEPTABLE DESCRIPTION OF SERVICES AS PART OF A PROPOSAL, THAT DESCRIPTION OF SERVICES CAN BE ATTACHED WITHOUT ANY TERMS, CONDITIONS, LIMITATIONS, ETC., FROM THAT PROPOSAL.]

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) (BALANCE OF PAGE LEFT BLANK) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement.

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part Consultant Scope of this Agreement.services includes:

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement.. Base Scope of Services

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement.. Consultant will provide the following services and/or deliverables for BOTH the Vallejo and Vacaville Centers respectively:

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) END OF DOCUMENT EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT CONSULTANT, COSTS, ADDITIONAL SERVICES AND HOURLY RATES Consultant’s entire Proposal is not made part of this Agreement.