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I <br />following <br />herehy affirm under ponrdty of <br />I certify on bola[ `of 5tudiofolia <br />----�.-....,......._.....,,�,_, that during the to <br />eoattrart With the nT it D vetl0i'loll'nttoe QY, ) <br />t�.. er �}', City Of Santa Ana, I wit t ni <br />any person in any a anne so as to become subjCot to the evorlCerS' Compealaation <br />California, and agr e tha� ifI Should become subject to the workers' competaSatb <br />Provisions of Seed tT 37 0 of the Labor COLIC, 1941811 forthwith Comply with tho; <br />provisiona. <br />DAB; S©pte ber 4, 2019 <br />i <br />By, <br />Name: James Dinh <br />Title: Principal <br />Telophono: <br />of my <br />employ <br />tws of <br />WARNING: FA B - 0 SECURE WOI KpRS, COMPBNSAI"ION COVB AGEIS <br />UNLAWFUL, AN SI• .LSUBJECT AN EMPJ-oyVj� T'O CRIMINAL PEN LTCC S <br />AND CIVIL PINB. UJP 1 O ONE HUNDRED TkIOUSAND DOLLARS ($100,0 0). IN <br />AMAGES AS POVIDE I <br />IN SRCTfON 370fi E �IB LOABOIZ COL"}II,�IN:I'B12LD",S1 AN[) A'C1 OItNE S B FOR <br />S <br />REVIEWED & APPROVED <br />By Risk MnNngcmt NT DivisiON <br />MAR 27? <br />