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State of the art risk management tools for public agencies <br /> <br /> <br />WORKERS’ COMPENSATION INSURANCE CERTIFICATION <br /> <br /> <br />TO: City of Pleasanton <br />RE: Safety Consulting (SOP, PSERPs) <br /> <br /> <br />The Consultant shall execute the following form as required by the California Labor Code, Sections 1860 <br />and 1861: <br /> <br />I am aware of the provisions of Section 3700 of the California Labor Code that requires every employer <br />to be insured against liability for workers’ compensation or to undertake self-insurance in accordance <br />with the provisions of that code. <br /> <br />As a Managing Partner of DKF Solutions Group, LLC, I verify that we do not have any employees who <br />will perform work under this agreement. In the event that DKF Solutions Group hires any employees to <br />perform work under this agreement, I will comply with the provisions of Section 3700 of the California <br />Labor Code before commencing or continuing the performance of the work under this contract, including <br />supplying City of Pleasantonwith proof of Workers’ Compensation Insurance and a Waiver of <br />Subrogation thereto. <br /> <br /> <br /> <br /> <br />__ DKF Solutions Group, LLC______________________ <br />Name of Firm (Person, Firm, or Corporation) <br /> <br />______________________________________________ <br />Signature of Authorized Representative <br /> <br />__Kay Patzer, Managing Partner____________________ <br />Name & Title of Authorized Representative <br /> <br />___28 August 2025____________________ <br />Date of Signing <br /> <br /> <br />170 Dogwood Lane <br />Vallejo, CA 94591-8056 <br />www.dkfsolutions.com <br />Docusign Envelope ID: 779599FB-0953-47CD-ACAF-1CEC2592A33C