HomeMy WebLinkAbout415 S H St - Engineering
HOLD HARMLESS AND
WAIVER OF LIABILITY AGREEMENT
Name:
~(I~1.O-
{)~\..~
Date:
ro Jo <f Ie /
.
Address: ~ , > ~
H-
Phone: 4[<:f7 - ~ ~~ </
In
consideration of approval of the following described work at: 0. II 0 W
1ft+- ".
~/> .s fJ 5;+. ~L,
for the purpose of: -tC'\LQ.. '(Yef......rr.r-o..l! b{"'tJOI
the undersigned on behalf of the property owners and their heirs
and assigns, hereby agrees to defend, indemnify, and hold the City of Port Angeles and its officials,
employees and agents, harmless against any claims and/or lawsuits for personal injury and/or
property damage arising out of, or in any way connected with, the above described proposal except
for injuries or damages caused by the sole negligence of the City. ...J:
Dated this 'I
day of J........I'-e-
~
V
2021.
I
~P- ()o-ra-
(Signature)
V'
J.
'\ \
-
SUBSCRIBED and sworn to me this!L: day Of/~--A'LP
20Qi
NOTARY PUBLIC in for the State of
, 'N aslHngten, residing l.uPuIt Angeles.
. My Co, mmission expires(X'7 ;;-:v.f -,(J ~,
. .~
- ~ ______ _.'___'__ _-;< - _...... n_ .......___ ._. _