Okaloosa County BOCC — May 17, 2016 — proposed hold harmless agreement

OKALOOSA COUNTY WATER & SEWER HOLD HARMLESS AGREEMENT The below listed Property Owner is the owner of a certain property located within Okaloosa County, Florida and described as parcel ID# 24-2S-24-0000-0132-0000 (the “Property”). The Property Owner does hereby agree to indemnify and hold harmless Okaloosa County, Florida, its Officers, Employees, Agents and Contractors working for or on behalf of the County, from a n y a n d all claims, damages, liabilities or expenses that may result from the actions or inactions of Okaloosa County, including its Officers, Employees, Agents and Contractors working for or on behalf of the County in the entry on to the Property and the demolition of a certain permanent structure that is located within a proposed 25 foot easement on the Property. This Indemnification and Hold Harmless is contingent upon the release of certain utility and drainage easements identified in Ordinance No. 100.123 adopted by the City of Ft. Walton Beach, Florida on May 26, 1970 and recorded in the official records of Okaloosa County BK. 2944, PG. 4352. This Hold Harmless shall become null and void after the completion of the demolition of the structure or after five years of the execution of this document.  I hereby acknowledge that I have read and understand the above agreement on this of _______________________ , 2016. Property Owner's Name Property Address Property Owner's Signature STATE OF FLORIDA ) COUNTY OF OKALOOSA ) Before me, the undersigned authority, personally appeared __________________________________ whom provided identification/ or to me well known and known to me to be the person described in and who executed the foregoing document and acknowledged to and before me that he has the full authority to execute and did execute said instrument in the capacity and for the purposes therein expressed. WITNESS my hand and official seal this day of , 2016. NOTARY PUBLIC My Commission Expires: