|
„roj-uLA,9' etint.t1(-
<br /> .\v oYk11/44)€ s
<br /> O (0.Aitil ,
<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 /> Also, as Applicant I certify that the information provided on this application is true and
<br /> correct.
<br /> ((()L,L 04 dd%in
<br /> _62/0 -e
<br /> SignatYre Dat
<br /> to A I C T:CICin
<br /> Printed Name
<br /> MbcTDr NI ' hkor5 /-03--,95-,) -0 a
<br /> Organization Represeg • Phone No.
<br /> List businesses/individuals impacted by the event that you have contacted and ask them to
<br /> sign off if they concur with the closure.
<br /> l Business�esljn giduals(print) S. 1,,,,... _-
<br /> 0 I .-
<br /> 8410411119111 Lig - 14;
<br /> 10
<br /> \.\-v k. 4. -14,11.:6-r- 4-43.-N..0c)5
<br /> ‘A,'41/1!:-Will X)
<br /> of AL.. 'Ir_hriinril
<br /> . ' 1)r?F' . 8 ___„%t _ , or
<br /> \o\)-'
<br /> coi-\>
<br /> ,_ 4, 67..
<br /> /i 10 r II 1. , �I��" �.%._ / 1, Jed
<br /> q . . _
<br /> 'Wk...
<br /> ..;' ` i l , C.-e i{- LeLLA.)So 11 . ► Magi... - �� � O ) 11' _
<br /> ‘� �
<br />
|