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EXHIBIT 1 <br />Prison to Employment Supportive Services Earn and Learn Grant <br />Form S: workers' Compensation Certification EDD RFA #84049 <br />The undersigned In submitting this document hereby certifies the following: <br />I am aware of the provisions of section 3700 of the California Labor Code which requires every <br />employer to be Insured against liability for workers" compensation or to undertake self- <br />insurance in accordance with such provisions before commencing the performance of the work <br />of this Agreement. <br />Samantha M. Lambert, Risk Management Sur <br />Name and Title (Print or Type) <br />City of Santa Ana <br />Firm Name <br />14-Feb•19 <br />Date - <br />20 Civic Center Plaza <br />Street Address <br />Santa Ana CA 92702 <br />City, State, Zip <br />25G-36 <br />