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05/13/2003 10:08 FAX 206 525 7645 American Heart Assoc. 1-, 1003 <br /> 114/Za/ZUUa3 is:lu FAA 4Z5 Z57 8741 CITY OF EVERETT I. <br /> Acknowledgement of Conditions & Certification <br /> As a matrial consideration to the City granting this approval, and without which the City <br /> would nc:t 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 /> demandssuits, losses or liability resulting at any time from injury to or death of any <br /> person o) 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 /> respectin; the perfoirnance of approval granted herein, .or otherwise arising or resulting <br /> from.the approval granted. With limiting the generality of the foregoing, the within <br /> indemmuiLcation by Applicant of City, its officers, employees and agents shall include <br /> indemnitcation 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 /> employes 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 liirbility for damages arising out of bodily injury to persons or damages caused by <br /> or resulting fiurn the sole negligence or willful misconduct of the City, its officers, <br /> employees or agents acting within their scope of employment. <br /> Also, as .:kpplicant I certify that the information provided on this application is true and <br /> correct- <br /> CAVA <br /> KLL* ./16:12' <br /> Sig Hare Date <br /> 6-1V—/Q <br /> Printld Name <br /> Organization Representing Phone No. <br /> List busivessea/individuals impacted by the event that you have contacted and ask them to <br /> sign off ii they concur with the closure_ <br /> Bnsinessesflndividuals (print) Signature <br /> 1. <br /> 3. <br /> 5, <br /> 6_ <br /> 7. <br /> 8 <br />