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Auto Liability (Non -Use Agreement) <br />Date 2-1 2D /Z6 Z tt <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />Re: Auto Insurance Requirement <br />Dear City of Santa Ana Risk Management Division: <br />Kcl'.f�ev (vto.— &4,Ete<has intent to enter into an agreement with the City of Santa <br />Ana.Throughout the course of this agreement, �o �l2erd�Cy�((¢f attests to the following: <br />1• {l�ev,�.4��� will not use/drive any vehicle during the course <br />and scope of the services provided in the agreement/contract. <br />2. tL�_✓ l.Le v (n0. Sx k --r will not use any owned/rented/leased vehicles <br />during thecourse and scope of the services provided in the agreement/contract. <br />3.consultants/independent contractors/employees <br />utilize their personal vehicles/non-company owned, borrowed, or rented/leased <br />vehicles for transportation to and from work and if applicable carry their own <br />automobile insurance. <br />By signing below, I, KtkevL"a SAte r attest that I possess the legal authority <br />to enter into an agreement with the City of Santa Ana as well as the legal authority <br />to attest to the statements above. If at any time it is found that <br />is not adhering to any/all statements in this document and has not provided the <br />minimum Auto liability insurance coverage of $1 million per occurrence, the contract <br />will be considered null and void andthe company will be held fully liable for any and all <br />damages. <br />Signature: <br />Name:<r✓��• naSti{{er' <br />Job Title: C�rkvac� l�s�r�elo�itu t ��Soktid4 <br />Company Name: l�erina S EEC r <br />Contact Phone: 94 q 2`10 q`{ gS <br />Email Address: k,Ek,zr(kje_, <br />Wmgmtad imi <br />REVIEV%EE�6 MPRWRav®BY: <br />' <br />�. <br />A..:, A,4,44. <br />Risk Management Spetiatist <br />