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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 AUTOMOBILE LIABILITY INSURANCE <br />I Thomas R. Holliman ('Representative"), attest that I am an authorized <br />(Name and Title of Vendor Representative) <br />representative of T.R. Holliman and Associates, Inc. (Company"), and <br />(Consultant/Company Name) <br />possess the authority to legally bind Company. <br />In my capacity as Representative of Company, I represent and confirm the following, as relates to the <br />agreement between Company and City of Santa Ana, agreement number <br />("Agreement") to provideengineering planning <br />(Services to be provided under agreementicontract) <br />("Services"): <br />During the course and scope of Company's agreement with the City of Santa Ana, <br />Company employees, consultants, representatives, and agents will not use and/or drive <br />any Company owned/rented/leased/borrowed vehicles to perform Services 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 minimum automobile liability insurance coverage as <br />required in the Agreement, it will be considered a breach of Agreement rendering the Agreement <br />null and void and Company will be fully liable for any and all damages. <br />Thomas R. <br />Thomas R. Holliman, P.E. Datlea1ly 20signed25.02.13y16:54:01 0800'liman, P.E. 2/13/2025 <br />Signature Date <br />Thomas R. Holliman, PE <br />Print Name <br />President/Managing Engineer <br />ritle <br />tomh@trholliman.com <br />Contact Information, i_e., Telephone Number and/or Email <br />Affidavit of Exemption for Automobile Liability Insurance 11.12.2024 <br />