Workers Comp Affidavit Template for Australia

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Key Requirements PROMPT example:

Workers Comp Affidavit

"I need a Workers Comp Affidavit for my construction company operating in New South Wales and Victoria, with 150 employees and multiple ongoing project sites, to be submitted for a government tender by March 2025."

Document background
The Workers Comp Affidavit is a crucial compliance document required in Australian jurisdictions to demonstrate adherence to workers' compensation insurance obligations. This document is typically required during tender processes, contract negotiations, or when engaging with government entities. The affidavit serves as a formal declaration under oath, where an authorized representative attests to the business's workers' compensation insurance coverage, compliance with relevant legislation, and accurate reporting of employee information. It may be requested by potential clients, government agencies, or principal contractors to verify insurance coverage before entering into business relationships or awarding contracts. The document's requirements can vary by state or territory, and it must be executed in accordance with local statutory declaration laws.
Suggested Sections

1. Affiant Information: Identifies the person making the affidavit, including their full name, position, and authority to make declarations on behalf of the business

2. Business Details: Essential information about the business including legal name, ABN, business structure, and principal place of business

3. Insurance Coverage Declaration: Detailed statement of current workers' compensation insurance coverage, including policy numbers and dates

4. Employee Information: Declaration of the number of employees and total payroll amount

5. Compliance Statement: Affirmation of compliance with relevant workers' compensation laws and regulations

6. Verification: Formal statement verifying that all information provided is true and correct to the best of the affiant's knowledge

7. Execution: Signature block with date and place of execution, witness details, and proper attestation

Optional Sections

1. Interstate Operations: Required when the business operates across multiple states or territories, detailing coverage in each jurisdiction

2. Contractor Statement: Needed when the business employs contractors, detailing their coverage arrangements

3. Claims History: May be required to declare any previous workers' compensation claims or incidents

4. Special Risk Categories: Required for businesses operating in high-risk industries or with special insurance arrangements

5. Self-Insurance Declaration: Needed if the business is self-insured rather than having commercial insurance

Suggested Schedules

1. Schedule A - Certificate of Currency: Copy of current workers' compensation insurance certificate

2. Schedule B - Employer Registration: Evidence of registration as an employer with relevant workers' compensation authority

3. Schedule C - Payment History: Proof of up-to-date premium payments

4. Schedule D - Risk Assessment: Workplace risk assessment documentation if required by the relevant authority

5. Schedule E - Interstate Certificates: Certificates of currency for other states/territories where applicable

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions
Relevant Industries

Construction

Manufacturing

Mining

Healthcare

Retail

Hospitality

Professional Services

Transport and Logistics

Agriculture

Education

Technology

Industrial Services

Real Estate

Financial Services

Relevant Teams

Human Resources

Legal

Compliance

Risk Management

Operations

Finance

Workplace Health and Safety

Procurement

Administration

Executive Leadership

Relevant Roles

Chief Executive Officer

Managing Director

Human Resources Manager

Compliance Officer

Risk Manager

Operations Manager

Finance Director

Legal Counsel

Workplace Health and Safety Manager

Procurement Manager

Contract Manager

Business Development Manager

Company Secretary

Facilities Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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