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' 1 WORKER'S COMPENSATION CERTIFICATION <br /> 2 <br /> 3 Contract No. E94-03 <br /> a <br /> s <br /> s <br /> 7 TO: Flag City, L.P. <br /> s c/o Dillon and Murphy Consulting Engineers <br /> 9 1820 W. Kettleman Lane, Suite E <br /> 10 Lodi, CA 95242 <br /> 11 <br /> 12 <br /> 13 1 am aware of the provisions of Section 3700 of the Labor Code of the State s <br /> 14 California which require every employer to be insured against liability for worker's <br /> 15 compensation or to undertake self-insurance in accordance with the provisions of that <br /> is Code, and I will comply with such provisions before commencing the performance of the <br /> 17 work of this contract. <br /> 18 <br /> 19 <br /> 20 <br /> 23 Bidder <br /> 24 <br /> 26 y <br /> Ho Title <br /> 31 <br /> 32 <br /> 33 <br /> 34 <br /> 1 35 <br /> 36 <br /> 37 Business Address <br /> 38 <br /> 39 <br /> 40 <br /> 41 <br /> 42 <br /> 43 Place of Residence <br /> as <br /> as <br /> as (This certificate must be executed by the successful bidder prior to the award of Contract. <br /> 47 The bidder may execute the certificate on this page at the time of submitting his proposal). <br /> 48 <br /> WORKER'S COMPENSATION CERTIFICATION <br /> F-1 <br />