140-26 INDEMNITY AND HOLD HARMLESS AGREEMENT - GREGORY AVENUE LED SPEED FEEDBACK SIGNS.pdf

Page 1 of 4 COUNTY OF ESSEX DEPARTMENT OF PUBLIC WORKS DMSION OF ENGINEERING INDEMNITY AND HOLD HARMLESS AGREEMENT For and in consideration of having been granted a permit for conducting physical improvements within an Essex County Right-of-Way on the Undersigned's premises, the Undersigned hereby indemnifies and holds harmless the County of Essex including but not limited to its Department of Public Works, Division of Engineering and their respective officers, employees, agents, elected and appointed officials from and against any and all claims, judgments, causes of action, costs or expenses asserted against or incurred by them or any of them arising out of any accident or injury sustained by any person(s) at the location during the period and after the expiration of the issued permit occasioned by the work performed by the Undersigned. The Undersigned agrees and understands that a part of said consideration for this Agreement shall include the Undersigned's promise that any rights to bring suit against the County and any rights to compensation there from on any matters arising from or otherwise related to Undersigned's participation in this improvement have been knowingly and willingly relinquished by the Undersigned under this Agreement. By affirming his/her signature to this document, the undersigned acknowledges that it understands the contents of this document and is voluntarily agreeing to its terms. The undersigned is authorized and holds the actual authority as the legally authorized owner/representative of the premises to enter into this agreement. In witness whereof I/we have hereunto set my/our hand and seal the ______ Day of ______ in the year ________ PROPERTY LOCATION: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ TYPE OF IMPROVEMENT:_________________________________________________________________________ DATE(S) OF PERMIT: _____________________________________________________________________________ _______________________________________________________________ Owner/ Representatives Name _______________________________________________________________ Signature Of Legally Authorized Owner/Representative _______________________________ Printed Name