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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 PROFESSIONAL LIABILITY INSURANCE <br /> 1, Tyson Koerper <br /> ("Representative"), attest that [am an authorized <br /> (Name and Title Toff Vendor Representative) <br /> representative of TK Creative, LLC ("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 N-2023-212 <br /> ("Agreement")to provide 'Graphic Design ("Services"): <br /> (Services to be provided under agreement/contract) <br /> During the course and scope of Company's agreement with the City of Santa Ana, <br /> Company will not use the services of an expert necessitating professional liability/errors <br /> & omissions liability insurance coverage in the performance of 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 professional 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 /> Tyson Koer Qr Digitally signed by Tyson Koerper <br /> p Date:2025.06.11 09:07:07-07'00. 6/11/25 <br /> Signature Date <br /> Tyson Koerper <br /> Print dame <br /> Owner <br /> Title <br /> 480-309-4482 • tkoerper@gmail.com <br /> Contact information.i,e„Telephone Number and/or Email Address <br /> Tu Tran ll Digitally signed by <br /> Tu Tran Nguyen <br /> APPROVED Nguyen 116:4238.0700'' <br /> By Tu Tran Nguyen at 4:42 pm,Jun 11,2025 <br /> Affidavit of Exemption for Professional Liability Insurance 11,112024 <br />