Laserfiche WebLink
170 Dog./vood lane <br /> Solutions Gr up ! Vallejo. CA 94591-8055 <br /> Wu/W,Clkf504 Jtion5.Con-) <br /> WORKERS' COMPENSATION INSURANCE CERTIFICATION <br /> TO: City of Santa Ana <br /> RE: Annual Safety Training <br /> The Consultant shall execute the following form as required by the California Labor Code, Sections 1860 <br /> and 1861: <br /> 1 am aware of the provisions of Section 3700 of the California Labor Code that requires every employer <br /> to be insured against liability for workers' compensation or to undertake self-insurance in accordance <br /> with the provisions of that code. <br /> As a Managing Partner of DKF Solutions Group, LLC, I verify that we do not have any employees who <br /> will perform work under this agreement. In the event that DKF Solutions Group hires any employees to <br /> perform work under this agreement, I will comply with the provisions of Section 3700 of the California <br /> Labor Code before commencing or continuing the performance of the work under this contract, including <br /> supplying City of Santa Ana with proof of Workers' Compensation Insurance and a Waiver of <br /> Subrogation thereto. <br /> DKF Solutions Group, LLC <br /> Namom <br /> orporation) <br /> Signature of Authorize presentative <br /> Kay Patzer, Managing Partner <br /> Name & Title of Authorized Representative <br /> 3 April 2025 <br /> Date of Signing <br /> STATE OF THE ART KISK MA.NA4EMENT TOOLS FOR, PUBLIC AGENCIES <br />