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Okaloosa County BOCC — April 27, 2013 — Hold Harmless — reading text
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HOLD HARMLESS AGREEMENT
The undersigned does hereby agree to indemnify and hold
Okaloosa County, the Okaloosa County Sheriff’s Department,
and their agents, employees, or officers, harmless from any
and all liability of any nature or kind resulting directly
or indirectly from (event title) WSA Beach Nationals
on (event date) March 23-24, 2013 beginning
at (insert time) sat. 8:30am and ending at (insert time}
Sun.6:15pm
The undersigned, does hereby certify that he/she has full
authority to ériter into this Agreement on behalf of
nee
sa Authentic Entertainment
Ly
¥gnatur Printed Name
WS Uz Le Yy FE a Wats Fav /acr-
Organization: Authentic Entertainment
Street Address: 2860 N Naomi st
City: Burbank State: Ca ZIp; 91504
Phone: 323-644-6144 ext. 221
ACKNOWLEDGMENT
The foregoing instrument was acknowledged before me
this day of , 20 ,
by who has acknowledged that he/she
has full authority to execute this instrument on behalf of
NOTARY PUBLIC
Personally Known OR Produced Identification
Type of Identification Produced:
State of California
County of Los Angeles
Subscribed g gd sworn i ee ried) ae
on this, ee af. , 20 {3 7AM &
a a5 HINA A
by ZONA Vere PUG AER. Gouw. # 1032888
ar NOTARY PUBLIC- CALIFORNIA 0
Los ANGELES COUNTY
Hy Coun. Exe, HAY 14, 2018
personally hows tote or proved to me on the
basks off satisfactory evidence to be the person
who “pe red before me,
tz Ke, Mee.
otary Public S