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CITY OF SANTA ANA ... <br /> Risk Management a division of Human Resources F, <br /> Managing Risk through Awareness and Action �'° <br /> AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE <br /> Linda Quiquivix <br /> 1, ("Representative"),attest that I am an authorized <br /> (Name and Title of Vendor Representative) <br /> THRIVE Santa Ana, Inc. <br /> representative of ("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 provide Artist Grant ("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 employees, consultants, representatives, and agents will not use and/or drive <br /> any Company owned/rented/leased/botzrowed 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 /> L. Q U Ifl U IV X Digitally signed by L. Quiquivix <br /> `1 Date:2025.07.02 15:32:45-07'00' <br /> Signature Date <br /> Linda Quiquivix <br /> Print Nam <br /> Director of Strategy and Administration <br /> rifle <br /> quiqui@thrivesantaana.org <br /> Contact information,i.e.,Telephone Number and/or Ismail Address <br /> Affidavit of Exemption for Automobile Liability Insurance 11.12.2024 <br />