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SMIJ0 Q Q U I N COMMUNITY DEVELOPMENT DEPARTMENT <br /> ——COUNTY TIME EXTENSION <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION: <br /> I, the Owner/Applicant/Agent agrees to indemnify, defend (with counsel reasonably approved by County), and hold <br /> harmless the County and its officers, officials, employees, agents, boards, and commissions (collectively"County") as <br /> follows: <br /> 1. INDEMNITY: <br /> A. From and against any and all claims, demands, actions, proceedings, lawsuits, losses, damages, <br /> judgments and/or liabilities arising out of, related to,or in connection with the application and applied for project or to <br /> attack, set aside,void, or annul, in whole or in part, an approval of the applied for project by the County,the adoption of <br /> environmental review documents related to the applied for project, and any related development approvals or project <br /> conditions for the applied for project(hereinafter"Claim"); <br /> B. For any and all costs and expenses incurred by the County on account of any Claim, except where such <br /> indemnification is prohibited by law, including but not limited to damages, costs, expenses, attorney's fees, or expert <br /> witness costs that may be asserted by any person or entity, private attorney general fees claimed by or awarded to any <br /> party against the County, and the County's costs incurred in preparing an administrative record which are not paid by the <br /> petitioner. <br /> C. Except as to the County's sole negligence or willful misconduct. <br /> 2. Defense: <br /> A. The County may participate or direct the defense of any Claim.The County's actions in defense of any <br /> claim shall not relieve me of any obligation to indemnify, defend, and hold harmless the County. <br /> B. In the event of a disagreement between County and me regarding defense of any Claim, the County shall <br /> have the authority to control the litigation and make litigation decisions, including, but not limited to, the manner in which <br /> the defense is conducted. <br /> I.' <br /> C. If the County reasonably determines that having common counsel presents such counsel with a conflict of <br /> interest, or if I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to <br /> the County, then County may utilize the Office of the County Counsel or employ separate outside counsel to represent or <br /> defend the County, and I shall pay the reasonable attorneys'fees and costs of such counsel. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner, trustee,trustor, or corporate officer)of the property(s) involved in this <br /> application, or <br /> Legal agent(attach proof of the owner's consent to the application of the properties involved in this application)and <br /> have been authorized to file on their behalf, and that the foregoing application tements are true and correct. <br /> Print Name: l.• Rbyldse. Signatur Date: Z1. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Page 2 of 2 <br /> Updated 0210212021 <br />