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Agmt23 Ashley Marie Blanco
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Agmt23 Ashley Marie Blanco
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Last modified
2/24/2023 4:14:11 PM
Creation date
2/24/2023 4:14:06 PM
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Template:
Agreement
Contractor Name
Ashley Marie Blanco
PROJECT NAME
Community Based Organization Professional Development RWCT
RMP File Number
304.5
Date
2/23/2023
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REV: 02-17-23 RL <br />EXHIBIT “B” <br />DECLARATION REGARDING WORKERS’ COMPENSATION INSURANCE AND <br />EMPLOYERS LIABILITY INSURANCE <br />Consultant certifies that it has only one employee, that such employee is a director of <br />the firm and that such 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 Section 3351 (c) of the <br />California Labor Code. Consultant agrees to purchase workers’ compensation <br />insurance if it retains any additional employees during the term of this agreement. Being <br />that the Consultant does not have any employees that are not owners of the firm, <br />Consultant does not carry Employer’s Liability Insurance. <br />ATTY/AGR.2023.026/Ashley Blanco (Small Team Dynamics Training) (Page 11 of 11)
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