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WORKERS' COMPENSATION INSURANCE CERTIFICATION <br />TO: City of Santa Ana <br />RE: Safety Training Agreement <br />The Consultant shall execute the following form as required by the California Labor Code, Sections 1860 <br />and 1861: <br />I am aware of the provisions of Section 3700 of the California Labor Code that requires every employer <br />to be insured against liability for workers' compensation or to undertake self-insurance in accordance <br />with the provisions of that code. <br />As a Managing Partner of DKF Solutions Group, LLC, I verify that we do not have any employees who <br />will perform work under this agreement. In the event that DKF Solutions Group hires any employees to <br />perform work under this agreement, I will comply with the provisions of Section 3700 of the California <br />Labor Code before commencing or continuing the performance of the work under this contract, including <br />supplying City of Santa Ana with proof of Workers' Compensation Insurance and a Waiver of <br />Subrogation thereto. <br />DKF Solutions Group, LLC <br />Na seai%3 rporation) <br />Signature of Authorize presentative <br />Kay Patzer, Managing Partner <br />Name & Title of Authorized Representative <br />22 April 2024 <br />Date of Signing <br />Rule Me aBeme dDhisiom <br />w/ REVIEWED&APPRO BY: <br />STATE OF THE ART RISK MANAGEMENT TOOLS FOR PUBLIC AGEN .9 ` Risk Management Spa <br />