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SITE ADDRESS: 7" `�Wr PERMIT I, the 0,Anar/Appllcantrllcensed Well Drilleripump Contractor agrees to Indemnify, defend with counsel reasonably approved by County, and hold harmless tta County and its officers, ol`cials, employees, agents, boards, and commissions (collectively'Counly") as follows: i. Indemnit: a. From yand against any and all claims, demands, actions, proceedings, lawsuits, losses, damages, Judgments andlor liabilities arising out of, related to, or in connection with the application and oppAed for well or pump or to attack, act aside, void, or annul, in whole or in part, approval or denial of the applied for permit by the County, and any environmental review documents related to the applied for permit; b. For any and all costs and expenses incurred by the County on account of any Claim, except where such Indemnification is prohibited by law, Including but not limited to damages, costs, expenses, attomey's fees, or expert Wtness costs that may be asserted by any person or entity, private attorney general fees claimed by or awarded to any party against the County, and the County's costs Incurred In preparing an administrative record which are not paid by the petitioner. C. Except as to lite County's sole negligence orwillful misconduct. 2 Defense: a. The County may participate or direct the defense of any Claim. The County's actions In defense of any claim shall not relieve me of any obligation to indemnify, defend, and hold harmless the County. b. In the event of a disagreement between County and me regarding defense of any Claim, the County shall have the authority to control the litigation and make litigation decisions, including, but not limited to, the manner In whlch the defense Is conducted. If County reasonably determines that having common counsel presents such counsel with a conflict of interest, or if I fall to promptly assume the defense of any Claim or to promptly employ counsel reasonably sausfaclory, to the County, then County may utllize the Office of the County Counsel or employ separate outside counsel to represent or defend the County, and 1 shall pay the rooscnablo attorneys' fees and costs of such counsel. I HEREBY CERTIFY THAT I'HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN CURRENT CANDNACTIVEIWITHCTHESTATE LAWS, AND RULES AND CALFORNIA ONTRACTORS STATE UICEINSE BOARD AND THONS. I ALSO AT LICENSEFY THAT MY REQUIRED AT t AM N COMPLIANCE ALL WORKERS COMPENSATION LAWS, PROPERTY OWNE SIGN:jf 1, I C ENSF.D :�' E:-1 • DRt LLER/P SIGN: PRINT.W`%J 0 IN DATE PRINT: DATE 3 fl 11 ZZ AUTHORIZAT� FOR OTHFItTHAN C-57 SIGNING PERMIT APPLICATION hereby authorize N•me et C-32 Licenced Auamrlicd Reprcwve;iec Nml Nuoe of AalMrixd Ail to sign this San Joaquin County Well & Boring Perinit Application on my behalf. l understand this authorization is valid for olio year and is limited to the work plan dated on the front page of this application. WNI , Pa:l.p Pc nw GHIx17.06 IM3.2021 hg; 2of: