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5 ,�P ._ <br />Affidavit of Sole Proprietorship <br />In reference to the City of San Marcos' contract for my provision of professional Wholesale <br />Power and Utility Consulting Services, I Frank McCamant, Principal of McCamant Consulting, LLC <br />certify that I do not have in force and effect a workers' compensation insurance policy to cover <br />myself or business because I have not elected coverage. I do not have any employees, and for the <br />term of the Agreement with the City will not hire employees. I have in full force and effect health <br />insurance coverage, disability insurance coverage and life insurance coverage to protect against my <br />injury or death sustained in the pursuit of my vocation, profession or business. <br />I understand and agree that the City of San Marcos will not be liable to me for any injuries I <br />may sustain arising out of my performance of work under this agreement. I and anyone entitled to <br />act on my behalf, waive and release the City of San Marcos, its employees, officers, agents, and <br />representatives and hold them harmless for any and all claims or liability for loss, injury or death that <br />I may suffer in performance of this agreement. <br />State of TxgS <br />County of S <br />being duly sworn deposes and says that s/he is <br />A41-,G1iQ of <br />and that all of the information and responses contained in this Affidavit are true And convect. <br />Subscribed and sworn to before me on this the ZCo day of �e <br />2015. <br />Notary Public, State bf <br />Notary stamp: <br />DAVID PETTY <br />Notary Public, State of Texas <br />MY Commission Expires <br />,8i,�•••` June 20, 2017 <br />