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WORKERS' COMPENSATION DEQAR&UQN <br />I Omar Velasco and Argelica Atilano hereby affirm under pen elty of perjury, the'. <br />trvsrnaet <br />following declaration : <br />I certify on behalf of, <br />Omar Velasco and Argelica Atilanp that,during the term <br />of my: <br />i�onsutianuCnmwu+YNamq) <br />contract for SpeakerlAuthox Proar ntatton event scrvlees with the City, of Santa Ana, I <br />wtll no employ gny pefsp�t Ta illy,, m ner aCr as,to come sablect to the <br />workers' <br />rF <br />conlp'ep attpn iasu 4f �F <br />° � � � <br />' <br />ty ` 1xShguld UeCtime �u6lect Co the <br />+ � <br />worke��a <br />IteipnCode <br />T Shall forthwith <br />i <br />xsCt>tn�If'��7k[�SatlOn <br />CGVCPae. <br />1j tt <br />i <br />KNIPP', <br />a <br />t Hd-fR'.SgN <br />rx <br />t.a <br />d <br />