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S I N' ELES <br />PO Box 431 <br />Rxesl Lake, MN 55025 <br />(612) 961 0292 <br />spne�esswonders,GOM <br />I <br />1, Kraig, Anderson hereby affirm under penalty of perjury, the followirl <br />declaratiot: <br />I <br />I certify on behalf of Spineless Wonders that during the, term of my contract for <br />butterfly enclosure building and consultation services with the City of Santa Ana, <br />I will not employ any person in any manner so as to become subject to the <br />workers" compensation laws of California, and agree that if I should become <br />subject to the workers'compensation provisions of Section 37'00 of the Labor <br />Code, I'shall forthwith comply with the provisions and provide proof: of' workers' <br />compensation coverage immediately, <br />11-4-2021 <br />Kraig Anderson <br />(612) 961-0292 <br />ep .. RAMwagmedDMsiun <br />40? 'S REVIEWED & APPROVED BY.- <br />F04c.�" z VX*vd <br />I' <br />RtWjanagementftalpt <br />