HomeMy WebLinkAbout5.1073 Original ContractWAIVER AND RELEASE
FOR AND IN CONSIDERATION of permission from J G;I! es r�� e
property owner of 1607 Lower Elwha or the right to enter on to private property to remove
contaminated soil from the City of Port Angeles automated packer diesel leak that occurred on
August 31, 2010.
Private property located at: 1607 Lower Elwha Road
The undersigned, for themselves, their heirs, successors and assigns, hereby waives,
releases, and forever discharges any claims against the City of Port Angeles or its employees for
personal injuries or damages arising out of the entry onto the above referenced property for the
purpose as set forth above.
Dated this 8 day of odra $k 2010.
i�
STATE OF WASHINGTON
ss:
COUNTY OF CLALLAM
On this day of(O .0 2010, before me, the undersigned, a Notary
Pub is in and for the State of Washington, duly commissioned and sworn, personally appeared
7: s p N to me known to be the individual described in and who
executed the foregoing instrument, and acknowledged to me the (X)he signed and sealed the said
instrument a her free and voluntary act and deed for the uses and purposes therein mentioned.
Given under my hand and official seal the day and year in this certificate first above written.
NOTARY PUBLIC in a for the State
Of Washington, residing at Port Angeles,
Washington.
5:ID73