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CITY OF SANTA ANA <br />Risk Management a division of Human Resources <br />Managing Risk through Awareness and Action <br />AFFIDAVIT OF EXEMPTION FOR PROFESSIONAL LIABILlTY INSURANCE <br />Gus Marquez ("Representative"),attest that I asn anaUthorized <br />representative of Greentech Landscape Inc (,,(,,ompany"), and <br />(('orisultanr/Cornpany Name) <br />possess tile authority to legally bind Company. <br />In any capacity as lZepresentative of Company, I represent and confirm the following, as relates to the <br />agreement between Company and City of Santa Ana, agreement number... <br />("Agree in en I") to provide. LnVioi,'> c e'l 19 -e ("Services"): <br />(services to he provided un(let agreement/cont, act) <br />During the COUrse and scope of (',"ornpany's agreement with the City of Santa Ana, <br />Company will not use the services cal' an expert necessitating professional liability/errors <br />& omissions liability insurance coverage in the performance ofServices to, for, or on <br />behalf of City of'Santa Ana. <br />if at any time it is found that Company is not adhering to any and/or all of the statements in this <br />document and does not maintain the rninirnurn professional liability insurance coverage as <br />required in the Agreement, it will be considered a breach of Agreement rendering the Agreement <br />null and void arid Company will be fully liable for any and all damages. <br />wMiTAMOM <br />Print Name <br />Title <br />PIC, ce-, r--A <br />lwcl cl P <br />...... ­­­ .... ..... . __1 ­­ -- -------- - --------- - -- — -------- . ...... . ­­...._ . . ..... .. <br />Colitact Inforrnation, I e., 'I'clephone Number andlor Email Address <br />Affidavit of Exemption for Professional Liability insurance 11.12.2024 <br />