TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
7551 Metro Center Drive, Suite 100
Austin, Texas 78744
If you are not certain whether all parties meet the requirement for entering into this agreement, you may wish to consult an attorney.
AGREEMENT BETWEEN GENERAL CONTRACTOR AND SUBCONTRACTOR
TO PROVIDE WORKERS' COMPENSATION INSURANCE
Notice of Agreement
The undersigned General Contractor and the undersigned Subcontractor hereby agree that the General Contractor ○ will withhold ● will not withhold the cost of workers' compensation insurance coverage from the Subcontractor's contract price and that, for the purpose of providing workers' compensation insurance coverage, the General Contractor will be the employer of the Subcontractor and the Subcontractor's employees. This agreement makes the General Contractor the employer of the Subcontractor and the Subcontractor's employees only for the purpose of workers' compensation laws of Texas and for no other purpose.