In consideration of services to be rendered to the undersigned and other good and valuable
considerations, the receipt of which are hereby acknowledged, the undersigned hereby releases the Village of Evendale, Ohio, and all its employees and agents from any and all liability resulting or arising from entrance and work of said employees and agents upon the premises known as ________________________________________ whether or not such entrance and work are within the scope of their employment and agency.
The undersigned further agrees to hold the said Village and its employees and agents harmless from any liability and/or damages resulting from acts of said employees and agents in and about said premises. The undersigned represent that they are the owners of said premises, have invited the Village of Evendale, Ohio, and its employees and agents upon the premises, and have the right to grant this release. This release shall be binding upon the undersigned, their heirs and assigns.
NOTE: If a Village vehicle (such as a dump truck) is used by a resident to discard debris,
the following items MAY NOT be loaded onto the trucks: chemicals, hazardous materials,
paint, oil, batteries, tires, appliances with freon, yard waste, grass clippings, leaves, tree limbs, hedge trimmings, sod and other plant material.
X _________________________
Signature
_________________________
Telephone No.
_______________________
Date
Preferred Date _________________________________
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