SAN 10AQUIN COMMUNITY DEVELOPMENT DEPARTMENT
<br />COUNTY- --
<br />SITE APPROVAL
<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 />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 />f 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 statements are true and correct.
<br />2
<br />Print Name: t;.L 3aAi pM& L-(-C Signature: i + Date: S
<br />Print Name: Signature: 1 Date:
<br />Print Name: Signature: Date:
<br />Print Name: Signature: Date:
<br />Print Name: Signature: Date:
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<br />Updated 08/28/2020
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