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WORKERS' COMPENSATION DECLARATION <br /> I Darrell K Wagner hereby affirm under penalty of perjury, the <br /> (Name/Title) <br /> following declaration <br /> I certify on behalf of Professional Entertainment TM that during the term of my <br /> (Consultant/Company Name) <br /> contract for Entertainment services with the City of Santa Ana, I will not employ any <br /> person in any manner so as to become subject to the workers' compensation laws of <br /> California, and agree that if I should become subject to the workers' compensation <br /> provisions of Section 3700 of the Labor Code, I shall forthwith comply with those <br /> provisions and provide proof of workers' compensation coverage. <br /> DATE: February 10, 2025 <br /> By: <br /> Name: Darrell Wagner <br /> Title: Owner <br /> Telephone: 800-801-2484 <br /> WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS <br /> UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES <br /> AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN <br /> ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR <br /> IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. <br />