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3 <br /> Indemnification, Hold Harmless, and Certification <br /> As a material inducement and consideration for the City granting this approval, the Applicant, <br /> on behalf of the sponsoring organization, hereby agrees to defend, indemnify and hold <br /> harmless the City from and against any and all Claims for personal injury, death, property <br /> damage or destruction, arising from, relating to, or resulting from the Event that is the subject <br /> of this approval. <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 damages, <br /> fees, and costs, including, but not limited to, attorney's fees, expert witness fees, court costs <br /> and other legal expenses. <br /> Provided, however, this agreement to defend, indemnify and hold harmless the City shall not <br /> apply to Claims arising out of bodily injury or death or property damage or destruction caused <br /> by the sole negligence or wilifull misconduct of the City. <br /> As Applicant, I certify that 1) the information provided on this application is true and correct; <br /> and 2) I am duly authorized by the sponsoring organization to make this application and enter <br /> into this agreement, on behalf of the sponsoring organization, to defend, indemnify and hold <br /> harmless the City. <br /> 1/rv/i% <br /> Signature Date <br /> b y-Q s. 1— las e71101-- <br /> Printed Name <br /> '►�oIt0o1 t~ art ,tvt d l_2s?22- g.3 9c <br /> Organization Representing P one No. <br /> List businesses/residences impacted by the event and ask them to sign off if they concur with <br /> the closure. <br /> Business/Residence Signature of approval <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 35 <br />