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TT 1111190 <br />Invoice will generate inside the paying party's Sterling Portal. Payment of the renewal fee must be received <br />by Sterling to finalize processing. To pay the renewal fee invoice for this service, login to your Sterling portal <br />and navigate to invoices. 0 Employer ❑ Broker ❑ General Agent <br />APPLICATION AGREEMENT/ SIGNATURE <br />We, the undersigned employer, affirm the accuracy of the information we have provided on this application and further affirm that <br />such information maybe relied upon for the preparation of this service by Sterling and maybe used for other related purposes. <br />We also agree to indemnify and hold harmless Sterling and its officers, directors, employees and agents (each of the foregoing <br />hereinafter referred to as an "indemnified party") from and against any and all actions, liabilities, claim, suits, damages, liens, <br />judgments, losses, fines, penalties, costs, and expenses (including attorneys' fees) arising out of or from the indemnified party's <br />services in connection with the preparation of this service <br />Dated this gth <br />Employer: city of Santa Ana - city Yard <br />Name: Lori Schnaider <br />Signature: Lori Schnaider <br />day of November 20 23 <br />Title: Human Resources Operations Manager <br />Digitally Mired by W Sd nalder <br />Data 2023.11 0916:19:28 -0 8'00' <br />