This government document is issued by Community Forest Advisory Committee for use in Los Angeles, CA
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https://www.google.com/url?client=internal-element-cse&cx=009475663812252016293:nieysy0e3cw&q=https://dpw.lacity.org/sites/g/files/wph1766/files/2021-03/Applicants%2520Declaration%2520of%2520Self%2520Insurance.pdf&sa=U&ved=2ahUKEwiXorf2v8v8AhXiTqQEHfodApg4MhAWegQIBxAB&usg=AOvVaw0Xk_x5p0wbAQRH_DpaccSL