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IWARMIRM <br />Consultant certifies that it has only one employee, that such employee is the sole <br />proprietor of the firm. As such, the employee has elected not to be covered by workers' <br />compensation insurance in accordance with an exception to the requirement of workers' <br />compensation insurance coverage as provided for under California law. Consultant <br />agrees to purchase workers' compensation insurance if it retains any additional <br />employees during the term of this contract. <br />By: <br />Printe /N�a%me: ZOO OrK-IYOOO <br />Title: U P 1✓ ('[' T <br />REV: 03-21-17 MI <br />Page 7 of 7 <br />ATTY/AGR.2017.052/Joanne Bond Coaching <br />