Common use of CERTIFICATE OF CONTRACTOR Clause in Contracts

CERTIFICATE OF CONTRACTOR. I, , certify that I am a/the (designate sole proprietor, partner in partnership, or specify corporate office, e.g., secretary) in the entity named as Contractor in the foregoing Contract. I hereby expressly certify that the name of the entity to which I am associated is ; that this entity is in good standing and has complied with all applicable laws and regulations, and that I have been expressly authorized by the proper parties in this entity to execute this contract on behalf of the above-named entity. Date By: Signature Name/Title (Please Print) ATTEST: By: Signature Name/Title (Please Print) Description of Contract: VISTA VALLEY VILLAS PRS PROJECT Name of Contractor: The above-named Contractor hereby acknowledges payment in full for all compensation of whatever nature due the Contractor for all labor and materials furnished and for all work performed on the above-referenced project for the period specified above with the exception of contract retention amounts and disputed claims specifically shown below. RETENTION AMOUNT FOR THIS PERIOD: $ DISPUTED CLAIMS DESCRIPTION OF CLAIM AMOUNT CLAIMED The Contractor further expressly waives and releases any claim the Contractor may have, of whatever type or nature, for the period specified which is not shown as a retention amount or a disputed claim on this form. This release and waiver has been made voluntarily by Contractor without any fraud, duress, or undue influence by any person or entity. Contractor further certifies, warrants and represents that all bills for labor, materials and work due Subcontractors for the specified period have been paid in full and that the parties signing below on behalf of Contractor have express authority to execute this release. Dated: (Print Name of Contractor) (Describe Entity: Partnership, Corporation, etc.) By: By: By: CONTRACTOR’S CERTIFICATE REGARDING WORKERS’ COMPENSATION Description of Contract: This work includes rock excavation into an existing slope and the construction of concrete masonry unit (CMU) retaining walls and concrete pad for a new pressure regulating station (PRS) installation. The work includes furnishing and installing a pre- designed PRS and tying into an existing water main in two (2) places with new valves and piping to connect the new PRS to the water system. Additionally, the work includes installing two (2) new valves in existing water mains and also removing an existing piping cross and connecting the two (2) piping runs together. Labor Code Section 3700: Every employer except the State shall secure the payment of compensation in one or more of the following ways:

CERTIFICATE OF CONTRACTOR. I, , certify that I am a/the (designate sole proprietor, partner in partnership, or specify corporate office, e.g., secretary) in the entity named as Contractor in the foregoing Contract. I hereby expressly certify that the name of the entity to which I am associated is ; that this entity is in good standing and has complied with all applicable laws and regulations, and that I have been expressly authorized by the proper parties in this entity to execute this contract on behalf of the above-named entity. Date By: Signature Name/Title (Please Print) ATTEST: By: Signature Name/Title (Please Print) Description of Contract: VISTA VALLEY VILLAS PRS PROJECT Name of Contractor: Period Work Performed: The above-named Contractor hereby acknowledges payment in full for all compensation of whatever nature due the Contractor for all labor and materials furnished and for all work performed on the above-referenced project for the period specified above with the exception of contract retention amounts and disputed claims specifically shown below. RETENTION AMOUNT FOR THIS PERIOD: $ DISPUTED CLAIMS DESCRIPTION OF CLAIM AMOUNT CLAIMED The Contractor further expressly waives and releases any claim the Contractor may have, of whatever type or nature, for the period specified which is not shown as a retention amount or a disputed claim on this form. This release and waiver has been made voluntarily by Contractor without any fraud, duress, or undue influence by any person or entity. Contractor further certifies, warrants and represents that all bills for labor, materials and work due Subcontractors for the specified period have been paid in full and that the parties signing below on behalf of Contractor have express authority to execute this release. Dated: (Print Name of Contractor) (Describe Entity: Partnership, Corporation, etc.) By: By: By: CONTRACTOR’S CERTIFICATE REGARDING WORKERS’ COMPENSATION Description of Contract: This work The Work includes, but is not limited to providing all labor, material and equipment to install approximately 665 linear feet (LF) of 12-inch diameter PVC C900 DR 14 water pipeline and connect into existing Cement Mortar Lined & Coated (CMLC) and Steel (STL) pipeline. Work includes rock excavation into an existing slope and the construction demolition, excavation, installation of concrete masonry unit (CMU) retaining walls and concrete pad below grade pipeline, corrosion protection for a new pressure regulating station (PRS) installation. The work includes furnishing and installing a pre- designed PRS and tying into an existing water main in two (2) places with new adjacent pipes, valves and piping appurtenances, backfill and compaction, asphalt paving, slurry sealing the roadway and all related work. Contractor is to connect the new PRS include removal of all spoils/debris as required. Fill dirt if required shall be certified tested and clear of any toxic substances and/or any corrosive materials. Traffic control to the water system. Additionally, the work includes installing two (2) new valves in existing water mains and also removing an existing piping cross and connecting the two (2) piping runs togetherbe included. Labor Code Section 3700: Every employer except the State shall secure the payment of compensation in one or more of the following ways:

CERTIFICATE OF CONTRACTOR. I, , certify that I am a/the (designate sole proprietor, partner in partnership, or specify corporate office, e.g., secretary) in the entity named as Contractor in the foregoing Contract. I hereby expressly certify that the name of the entity to which I am associated is ; that this entity is in good standing and has complied with all applicable laws and regulations, and that I have been expressly authorized by the proper parties in this entity to execute this contract on behalf of the above-named entity. Date By: Signature Name/Title (Please Print) ATTEST: By: Signature Name/Title (Please Print) Description of Contract: VISTA VALLEY VILLAS PRS DENTRO DE LOMAS STREET IMPROVEMENT PROJECT Name of Contractor: Period Work Performed: The above-named Contractor hereby acknowledges payment in full for all compensation of whatever nature due the Contractor for all labor and materials furnished and for all work performed on the above-referenced project for the period specified above with the exception of contract retention amounts and disputed claims specifically shown below. RETENTION AMOUNT FOR THIS PERIOD: $ DISPUTED CLAIMS DESCRIPTION OF CLAIM AMOUNT CLAIMED The Contractor further expressly waives and releases any claim the Contractor may have, of whatever type or nature, for the period specified which is not shown as a retention amount or a disputed claim on this form. This release and waiver has been made voluntarily by Contractor without any fraud, duress, or undue influence by any person or entity. Contractor further certifies, warrants and represents that all bills for labor, materials and work due Subcontractors for the specified period have been paid in full and that the parties signing below on behalf of Contractor have express authority to execute this release. Dated: (Print Name of Contractor) (Describe Entity: Partnership, Corporation, etc.) By: By: By: CONTRACTOR’S CERTIFICATE REGARDING WORKERS’ COMPENSATION Description of Contract: This work includes rock excavation into an existing slope The project includes, but is not limited to providing all labor, material and equipment to sawcut, remove and, reconstruct approximately 8,328 square feet of asphalt concrete pavement over aggregate base (new pavement section shall be 3 inches asphalt concrete over 4 inches aggregate base); remove and reconstruct approximately 431 lineal feet of asphalt concrete dike (including 2-inch thick asphalt concrete pavement under the dike); and the construction adjustment to grade of concrete masonry unit one (CMU1) retaining walls water valve well cover to grade. All work shall be performed in accordance with the Excavation Permit issued by the County of San Diego Department of Public Works. Traffic control shall be in accordance with San Diego County standards and concrete pad for a new pressure regulating station (PRS) installation. The work includes furnishing and installing a pre- designed PRS and tying into an existing water main in two (2) places with new valves and piping to connect the new PRS to Excavation Permit issued by the water system. Additionally, the work includes installing two (2) new valves in existing water mains and also removing an existing piping cross and connecting the two (2) piping runs togetherCounty of San Diego Department of Public Works. Labor Code Section 3700: Every employer except the State shall secure the payment of compensation in one or more of the following ways:

CERTIFICATE OF CONTRACTOR. I, , certify that I am a/the (designate sole proprietor, partner in partnership, or specify corporate office, e.g., secretary) in the entity named as Contractor in the foregoing Contract. I hereby expressly certify that the name of the entity to which I am associated is ; that this entity is in good standing and has complied with all applicable laws and regulations, and that I have been expressly authorized by the proper parties in this entity to execute this contract on behalf of the above-named entity. Date By: Signature Name/Title (Please Print) ATTEST: By: Signature Name/Title (Please Print) Description of Contract: VISTA VALLEY VILLAS PRS PROJECT SEWER PIPE LINING Name of Contractor: Period Work Performed: The above-named Contractor hereby acknowledges payment in full for all compensation of whatever nature due the Contractor for all labor and materials furnished and for all work performed on the above-referenced project for the period specified above with the exception of contract retention amounts and disputed claims specifically shown below. RETENTION AMOUNT FOR THIS PERIOD: $ DISPUTED CLAIMS DESCRIPTION OF CLAIM AMOUNT CLAIMED The Contractor further expressly waives and releases any claim the Contractor may have, of whatever type or nature, for the period specified which is not shown as a retention amount or a disputed claim on this form. This release and waiver has been made voluntarily by Contractor without any fraud, duress, or undue influence by any person or entity. Contractor further certifies, warrants and represents that all bills for labor, materials and work due Subcontractors for the specified period have been paid in full and that the parties signing below on behalf of Contractor have express authority to execute this release. Dated: (Print Name of Contractor) (Describe Entity: Partnership, Corporation, etc.) By: By: By: CONTRACTOR’S CERTIFICATE REGARDING WORKERS’ COMPENSATION Description of Contract: This work The project includes rock excavation into an existing slope 538’+/- of 8-inch diameter sanitary sewer pipe cured in place pipe lining underneath I-15, from manhole I6-#49 to I6#50, and; 516’ +/- 6-inch diameter sanitary sewer pipe from manhole J-4 # 9 to Fallbrook Lift Station piping. Also included is, all related traffic control, jobsite cleanup, coordination with property owner, and the construction of concrete masonry unit (CMU) retaining walls and concrete pad for a new pressure regulating station (PRS) installation. The work includes furnishing and installing a pre- designed PRS and tying into an existing water main in two (2) places with new valves and piping to connect the new PRS to the water system. Additionally, the work includes installing two (2) new valves in existing water mains and also removing an existing piping cross and connecting the two (2) piping runs togethermaterial supply. Labor Code Section 3700: Every employer except the State shall secure the payment of compensation in one or more of the following ways: