HomeMy WebLinkAbout17948 (17) CITY OF DIAMOND BAR /–� .
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21825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 PRESS �
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Q COMPENSATqN,AS PROVIOED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U
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Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS RE�UIRED BV SECTION ///�����'
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G3 SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE
N WORKERS'COMPENSATIONLAWSOFCALIFORNIANJDAGREETHATIFISHWLDBECOM INSPECTIONFEE
� SU&IECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTqN 37 'THE ,
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J SEC710N 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES.
OC RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THEHE IS A CONSTRUCTION IENDING AGENCV �
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� I AGREE TO COMPLV WITH ALL CfTY AND COUNTV ORDINANCES AND STATE LAWS RELATINO TO BUILDINO � A \11�1
� CONSTRUCTION,AND HEREBV AUTHORIZE fiEPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE �� "']�C�/( �y.�, r�
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SEWER FINAL ENG.
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