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EXHIBIT "B" <br />CERTIFICATION STATEMENT <br />Consultant certifies that it has only one employee, that such employee is the sole proprietor <br />of the firm. As such, the employee has elected not to be covered by workers' compensation <br />insurance in accordance with an exception to the requirement of workers' compensation <br />insurance coverage as provided for under California law. Consultant agrees to purchase <br />workers' compensation insurance if it retains any additional employees during the term of <br />this contract. <br />CONSULTANT: <br />a <br />Paul Causey dba Causey Consulting <br />733 Cree Court <br />Walnut Creek, Ca 9459 <br />Date: 4 � 22 l ( 7 <br />Page 12 of 12 <br />REV: 04-27-17 EI <br />ATTY/AGR.2017.089/Causey Consulting - Sanitary Sewer Management Plan Update <br />