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1 <br /> Indemnification, Hold Harmless, and Certification <br /> As a material inducement and consideration for the City granting this approval, the <br /> Applicant, on behalf of the sponsoring organization, hereby agrees to defend, indemnify <br /> and hold harmless the City from and against any and all Claims for personal injury,death, <br /> property damage or destruction, arising from,relating to, or resulting from the Event that <br /> is the subject of this approval. <br /> • <br /> "City" shall mean the City of Everett, its officers, employees and agents. <br /> "Claims" shall mean any actions, demands, suits, obligation or liability for payment of <br /> damages, fees, and costs, including, but not limited to, attorney's fees, expert witness <br /> fees,court costs and other legal expenses. <br /> Provided, however, this agreement to defend, indemnify and hold harmless the City shall <br /> not apply to Claims arising out of bodily injury or death or property damage or <br /> destruction caused by the sole negligence or willfull misconduct of the City. <br /> As Applicant, I certify that 1) the information provided on this application is true and <br /> correct; and 2) I am duly authorized by the sponsoring organization to make this <br /> application and enter into this agreement, on behalf of the sponsoring organization, to <br /> defend, indemnify and hold harmless the City. <br /> "4-7•64/p1/7), / /00//I/a 9 <br /> Signature Date <br /> gdi 176 6 e/rn ars <br /> Printed Name <br /> 5 e 11 yChap' ' <br /> Organization Representing Phone No. <br /> List businesses impacted by the event and ask them to sign off if they concur with the <br /> closure. <br /> Businesses Signature of approval <br /> 1. _. - -. <br /> 2. <br /> 3. _..... <br /> 4. - - - <br /> 5. —..__.._ _ _ <br /> 6. — <br /> 1'�t°..;/040,11 <br /> 40fi--r=-/ 6tisi'nesses ava� �6 v4r-' <br /> Vi e&�n J a� cry <br /> 044 Ge , 14-11 -re_ -ai orc,6 Ie <br /> •3 <br />