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<br />Roberto Zavala <br />I,,herebyaffirmunderpenaltyofperjury,the <br />(Name/Title) <br />following declaration: <br />Cosmos Event Rentals <br />Icertifyonbehalfofthatduringtheterm <br />(Consultant/Company Name) <br />City of <br />Event Rentals <br />of mycontractforserviceswith <br /> (Type of service provided) (Business Name) <br />Santa Ana <br />,Iwillnotemployanypersoninanymannersoastobecome <br />subjecttothecompensationlawsofCalifornia andagreethatifI <br />shouldbecomesubjecttothecompensationprovisionsofSection3700 <br />oftheLaborCode,Ishallforthwith complywiththeprovisionsandprovideproofof <br />compensationcoverage immediately. <br />Date: <br />1/22/2024 <br />Print Name: <br />Roberto Zavala <br />Print Title: <br />Owner <br />Signature: <br />Telephone: <br />714-569-1638 <br />WARNING: UNLAWFUL AND <br />SHALLSUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDRED <br />THOUSANDDOLLARS($100,000).INADDITIONTOTHECOSTOFCOMPENSATION,DAMAGESAS <br />PROVIDEDFORINSECTION3706OFTHELABORCODE,INTEREST,ANDFEES. <br />