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4
<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.----V With limiting_the_geneaality__of_the_._foxegoing,_-the
<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 /> \t MOM - 51901
<br /> Signature Date
<br /> anr; ki0 (AMS
<br /> Printed NameNOOk-P
<br /> -461
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<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
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<br /> 3. GZ -bxr>ent tj_.w Oda' 6544-516
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