Common use of WCB Clearance Certificates Clause in Contracts

WCB Clearance Certificates. Advise contractor that TIR will not release any funds for payment until Workers Compensation Board Clearance Certificate has been received by TIR. PROJECT: DATE: CONTRACTOR: WORK BEING PERFORMED: Print Name Print Name Project Manager/Inspector Contractor Representative (Sign) (Sign) ÐMeans Yes ☒ Means No N/A Not Applicable 1. Safety Policy Submitted □ 13. GFCI Requirements □ 2. Safety Representative □ 14. Accident/Incident □ Investigations Notification

WCB Clearance Certificates. Advise contractor that TIR will not release any funds for payment until Workers Compensation Board Clearance Certificate has been received by TIR. PROJECT: DATE: CONTRACTOR: WORK BEING PERFORMED: Print Name Print Name Project Manager/Inspector Contractor Representative (Sign) (Sign) ÐMeans oMeans Yes ☒ Means No N/A Not Applicable 1. Safety Policy Submitted □ 13. GFCI Requirements □ 2. Safety Representative □ 14. Accident/Incident □ Investigations Notification

WCB Clearance Certificates. Advise contractor that TIR will not release any funds for payment until Workers Compensation Board Clearance Certificate has been received by TIR. PROJECT: DATE: CONTRACTOR: WORK BEING PERFORMED: Print Name Print Name Project Manager/Inspector Contractor Representative (Sign) (Sign) ÐMeans Yes ☒ Means No N/A Not Applicable 1. Safety Policy Submitted □ 13. GFCI Requirements □ 2. Safety Representative □ 14. Accident/Incident □ Investigations Notification 3. Emergency Procedure Review □ 15. Verbal, Written, Gone □

WCB Clearance Certificates. Advise contractor that TIR will not release any funds for payment until Workers Compensation Board Clearance Certificate has been received by TIR. PROJECT: DATE: CONTRACTOR: WORK BEING PERFORMED: Print Name Print Name Project Manager/Inspector Contractor Representative (Sign) (Sign) ÐMeans oMeans Yes ☒ Means No N/A Not Applicable 1. Safety Policy Submitted □ 13. GFCI Requirements □ 2. Safety Representative □ 14. Accident/Incident □ Investigations Notification 3. Emergency Procedure Review □ 15. Verbal, Written, Gone □

WCB Clearance Certificates. Advise contractor that TIR will not release any funds for payment until Workers Compensation Board Clearance Certificate has been received by TIR. PROJECT: DATE: CONTRACTOR: WORK BEING PERFORMED: Print Name Print Name Project Manager/Inspector Contractor Representative (Sign) (Sign) ÐMeans oMeans Yes ☒ Means No N/A Not Applicable 1. Safety Policy Submitted □ 13. GFCI Requirements □ 2. Safety Representative □ 14. Accident/Incident □ Investigations Notification