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3 <br /> Acknowledgement of Conditions & Certification <br /> As a material consideration to the City granting this approval, and without which the City <br /> would not do so, Applicant agrees to and does hereby indemnify and hold the City, its <br /> officers, employees and agents harmless from and against any and all claims, actions, <br /> demands, suits, losses or liability resulting at any time from injury to or death of any <br /> person or persons, and or damage to any and all property occurring or arising from this <br /> approval, or resulting from any non-compliance with any law, ordinance or regulation <br /> " respecting the performance of approval granted herein, or otherwise arising or resulting <br /> from the approval granted. With limiting the generality of the foregoing, the within <br /> indemnification by Applicant of City, its officers, employees and agents shall include <br /> indemnification from any claim, action, demand, cause of action, suit, or proceeding, and <br /> said indemnification shall in all events include any and all attorney's fees, court costs and <br /> other legal expenses, and shall include the obligation of Applicant to appear in and <br /> defend any and all such claims, actions, or other legal proceedings whether judicial, <br /> quasi-judicial, administrative or otherwise, against or affecting City, its officers, <br /> employees and agents arising out of or pertaining to the approval granted herein. <br /> This paragraph does not purport to indemnify the City, its officers, employees and agents <br /> against liability for damages arising out of bodily injury to persons or damages caused by <br /> or resulting from the sole negligence or willful misconduct of the City, its officers, <br /> employees or agents acting within their scope of employment. <br /> f Also, as Applicant I certify that the information provided on this application is true and <br /> correct. - <br /> 11-4/AM 0* Lel 2,0 1 1 ij <br /> Y Signature Date <br /> \Lam € \NMl i Ovens <br /> ,N• Printed Name <br /> ... v ‘01CAOR / 11°.)CAL Wairik t <br /> 2-'i3 1614L1 <br /> Organization Representing Phone No. <br /> jList businesses/individuals impacted by the event that you have contacted and ask them to <br /> o sign off if they concur with the closure. <br /> 2 Businesses/Individuals(print) �i <br /> 011iNlitS 352A 06413)(1 <br /> 2. AOA, t9bc . . 6Z6/Nc f l�J <br /> 3. A �� kll e---Itt cl et.e xi e3(' [r / � a� i' <br /> -I— 4. -:::ol cAr ..9 -3‘;"--0 Noy-lon 419111V‘ -,e,<-!_sar--- / <br /> 3 s 6. LQ � l d 1 )1:34-Ir-O‘'r• <br /> s .*_ A.-,-w:sz'fiii_____,-17--9-1—'-it <br /> W <br /> A 1 --(b- s4cr,d s6.0)._ Pdf- -0y) %/ e ''y <br /> j 5 l k moo( ± 1,�s�iy <br /> -frx <br /> • 3ko? �� d CAv <br /> 3,S1� �t3„. „, <br />