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<br />Date: d I' [) (' ~~ <br /> <br />I, C ~ 1/, r~ c:!. / e J/' ^ / affirm under penalty of perjury, the following <br />declaration: - <br /> <br />I certifY that during the term of my contract with the City of Santa Ana, I will not <br />employ any person in any manner so as to become subject to the worker's compensation <br />laws of the State of California. An agree that if! should become subject tp the worker's <br />compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply <br />with those provisions. <br /> <br />(!~~ <br />~ <br /> <br />Signed: <br /> <br />C. B. GLENN TILE <br /> <br />CITY AGREEMENT #N-2002-154 <br /> <br />D AfTO FORM <br />( ( <br />TINE LEE SHAW <br />." City Attorney <br />DepU., <br /> <br /> <br /> <br /> <br />. <br /> <br />CAO"'25FEB'OJAM 1 0:07 <br /> <br />1 'd <br /> <br /> <br />1 :!E'1l.l <br /> <br />eEl'SO EO sa qa~ <br />