Hold Harmless Agreement Fence Permit Page 1 (Space reserved for Clerk) PROCESS NO. _________________________ HOLD HARMLESS AGREEMENT (Fence Permit) WHEREAS, the undersigned, _____________________________________, is the owner of the property described as: and located at ____________________________________________, Miami-Dade County, Florida, and WHEREAS, the undersigned has applied to the Miami-Dade County Department of Planning and Zoning for a fence process number ___________________. NOW THEREFORE, in consideration of the issuance of the fence permit _______________ the undersigned hereby agrees as follows: [f:/forms/Hold Harmless Agreement-fence permit (2).doc (4/17/08)] American LegalNet, Inc. www.FormsWorkflow.com Hold Harmless Agreement Fence Permit Page 2 Space reserved for Clerk) 1. To indemnify and hold harmless Miami-Dade County and its agents and authorized personnel from any and all claims, liability, losses and causes of action in any connection whatsoever with the issuance of said permit. 2. To defend, pay or settle any and all suits, liabilities, claims against Miami-Dade County and its agents and authorized personnel asserted by third persons, and to pay all claims, losses, judgments, costs and attorneys’ fees and other expenses in connection therewith. 3. To pay or settle claims for injury, loss or damage to personnel or property arising out of or in connection with the issuance of said permit. Signed, witnessed and acknowledged this ____ day of ___________________, ______. WITNESSES: _____________________________ Signature ________________________________ Owner _____________________________ Print Name ________________________________ Print Name _____________________________ Signature Address: ________________________________ _____________________________ Print Name ________________________________ ________________________________ STATE OF FLORIDA COUNTY OF DADE The foregoing instrument was acknowledged before me this _______ day of ________________________, ________, by ___________________________________, who is personally known to me or who has produced _______________________________, as identification. _________________________________ Notary Public _________________________________ Print Name My Commission Expires: [f:/forms/Hold Harmless Agreement-fence permit (2).doc (4/17/08)] American LegalNet, Inc. www.FormsWorkflow.com