2016/06/01 Council Agenda Packet

7 Indemnification, !Mil 1-Ini'ttfl4,9y, n11i1ilial L riii • As a material ltldtteenteat and eatvideirttIwl rar the City ttrritithig 11119 nppru'/iil, the Applfc int,r r1 E N111111 01 the sponsoring; organization, hereby til{rco to dt f,ul, Inticnmity mid hold ImrralcrYr die City from and against any mid till Claims I1.ir petsnnril injury, death, hrlipelty chitin o or destruction, arising from, refitting to, air resulting lrrinl the [?vent that i i the rtiihic=A of thi'f approval. "City",shull mean the City of Everett, its officers,employees and agents, "Claims" shall mean any actions, demands, suits, obligation or liability for payment of damages, fees, and costs, including, but not limited to, attorney's fees, expert witness li:r:s, court cn',t•i and other legal expenses, Provided, however, this agreement to defend, indemnify and hold harmless the City shall not apply to Clai'ins arising out of bodily injury or death or property damage or destruction caused by the sole negligence or willful misconduct of the City. • As Applicant, I certify that I).the information provided on this application is true and correct; and 2) I nm duly authorized by the sponsoring organization to make this application and enter into this agreement, on behalf of the sponsoring organization, to defend, indemnify and hold harmless the City, • 65.6q. 16, Signature Date • 10ha- (2- n h& • Printed Name Co WI nflt.t r(t,��l 6 c net <--ids S '-}25 .312 .D92 S Organization Rcpresentin Phone No. List businesses/residences impacted by this event. You must also obtain an approval signature from each business/resident indicating they concur with the closure. Business/Residence Signature of approval • i.412,ilnnex- Ye u-1 I 0/ 2, 64441 Cay/a. Paid LA-II/sop S. a-t,,/t) W.i.t.��,.r� 3. 4. S. • G. 7. 67