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CITY OF SANTA ANA <br />Project No. 14-2606: Fisher Park Butterfly and Bird Habitat <br />Project No, 13-7515: Centennial Park Slope Repair <br />PRQPQSAL AND t:ONTRAC7' At ENT <br />WORKERS' COMEENSYMON INSURANCE CER'T'IFICATION <br />As required by California Labor Code Section 1860 and 1861, the Contractor certifies as follows: <br />I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be <br />insured against liability for worker's compensation or to undertake self-insurance in accordance with tile <br />provisions of the Code, and I will comply with such provisions before commencing the performance of <br />the work of this contract. <br />If 1, as the Contractor, now or at any time during the course of this agreement, quality as all employer <br />tinder California Labor Code Section 3300, unless the hired emptoyee(s) is (are) persons excluded by <br />said Labor Code, I shall furnish the City of Santa Ana with an insurance certificate from my workers' <br />compensation insurance carrier certifying that I carry such insurance and that the policy shall not be <br />canceled nor the coverage,rfe/ except. upon thirty (30) days prior written notice to the City of Santa <br />Ana, <br />Signed <br />Title <br />Firm Hondo Com arry, Inc. <br />Date 04/17/2013 <br />TO BE INCLUDED IN BID PACKAGE <br />BP 9 of 29 <br />