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3B. No Se~Insacrance Fu~ad. <br />a. If Lessee does not maintain aself-insurance fund, please complete the following: <br />Lessee obtanis funds to pay claims for which it has self-insured from the following sources: <br />b. The limitations on the amounts payable for claims from the above sources are as follows: <br />4. Autl2ority. <br />a. The following entity or officer has authority to authorize payment for claim: <br />Under $5,000 City Manager or City Attorney. Over $5,000 City Council <br />b. In the event the entity or officer named m the prior response denies payment of a claun, does the claunant have recourse to <br />another administrative officer ncy or the courts? <br />YES NO (circle one) <br />If yes, to whom does the claimant have recourse? <br />Claimant can file lawsuit in court. <br />5. Certificates oflnsurance. <br />Attached hereto are copies of certificates of insm-ance with respect to policies maintained by Lessee. <br />IN WITNESS WHEREOF, Lessee has caused this Questionnaire to be executed as a supplement to the representations of Lessee in the <br />Agreement by its duly authorized officer- <br />CITY OF SANTA ANA, <br />Lessee <br />By: <br />Name: Franciso Gutierrez <br />Title: Executive Director,Finance <br />Date: March 19, 2008 <br />Telephone: 714/647-5422 <br />Facsimile: 714-647-5414 <br />Attachment <br />29 <br />3/ 18/2008 N BQ-HSC. DOGrev.01 /Oisdc <br />