Res 2009-170 - Laserfiche WebLink

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k t{q? \4A RC'lki Attachment B Affidavit of Limited Liability Corporation In reference to the City of San Marcos contract for consulting services in connection with the City's development of a Form Based Code for the Department of Development Services, the undersigned persons are shareholders of PlaceMakers, LLC. As a limited liability corporation PlaceMakers, LLC has no paid employees, including its shareholders, and does not have in force and effect a workers' compensation insurance policy to cover itself. The corporation represents that it does not have any employees, and for the term of the Agreement with the City will not hire employees. The individual shareholders of the LLC have in force and effect health insurance coverage, disability insurance coverage and life insurance coverage to protect against injury or death sustained in the pursuit of their vocation, profession or business. We understand and agree that the City of San Marcos shall not be liable to any of us for any injuries that may be sustained arising out of the performance of work under this agreement. PlaceMakers, LLC and anyone entitled to act on its behalf, waive and release the City of San Marcos, its employees, officers, agents, and representatives and hold them harmless for any and all claims or liability for loss, injury or death that may be suffered in the performance of this Agreement. Province of Manitoba 8tate-if City of Winnipeg Hazel M. Borys , being duly sworn deposes and says that s/he is managing Principal and President of PlaceMakers, LLC and that all of the information and responses contained in this Affidavit of Limited Liability Corporation are true and correct Subscribed and sworn to before me on this the 8th day of December , 2009. /n ?v v Province o anitoba Notary Public, State of ,. i PlaceMakers, LLC Agreement 18