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Acknowledtement 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 />S gnatureDate <br />--Be P--,v--u Fu I ( I_eY <br />Printed Name <br />L4 <br />Organization Representing 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 />Businesses/Individuals (print) Signature <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />0, <br />s., <br />