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E123753 This page is part of your document - DO NOT DISCARD 1 1 1 1 1 IIl IlI 1 1111 lllI 1 IIIll ll 111111 111111 lull 11 1 RECDVED 1 lll 1 V JUL 262010 CITY OF ARCADIA CITY CLERK 1 0100719003007 00002673427 00278684 SEQ: 01 Recorded /Filed in Offcial Records Recorder's Offce, Los Angeles County, California iu 20100984366 11 i Il 11 1 07/19/10 AT 02:26PM 11 1111 1 11 IB ins 1 DAR - Mail (Hard Copy) 11 11 NI 1 1 1 THIS FORM IS NOT TO BE DUPLICATED -) ') III 11111 11 IIV 11 0004: FEES: 24.00 TAXES: 0.00 OTHER: 0.00 PAID: 24.00 ECORDING REQUESTED BY WHEN RECORDED MAIL TO \/ NAME Phil Wray City Engineer . MAILING ,/ City of Arcadia PO Box 60021 jArcadia CA 91066 - CITY, STATE 6021 ZIP CODE J \ II 20006 a SPACE ABOVE THIS LINE RESERVED FOR RECORDER'S USE TITLE(S) HOLD HARMLESS AGREEMENT FOR PROJECT IN PUBLIC RIGHT OF WAY CORDING REQUESTED i AND WHEN RECORDED MAIL TO: City Clerk of the City of Arcadia 240 W. Huntington Dr. Arcadia, CA. 91007 This Agreement is made and entered into by and between the City of Arcadia, a municipal, organization organized under the laws of the State of California (City), and Thomas Heer and Carla Tiger (Owner) and cannot be modified or terminated without written approval of the City. Property Address: 77 Woodland Lane, Arcadia CA 91006 Assessor's Parcel Number: 5770 - 003 -014 Re: Project Description: 5 -Foot wrought iron fence installed in public right -of -way approximately 4'3" from curb along Woodland Lane from gate to south property line In consideration of and as a condition to issuance of an off -site or encroachment permit for the above described obstruction(s), the undersigned agrees to indemnify, defend, and hold harmless the City of Arcadia, its officers, agents, and employees from and against all losses, claims, demands, payments, suits, and judgements of every nature and description brought or recoverable against it or them (the City et. al.) by the owner, his agents or employees, or third parties arising out of or in any way attributable to the above job. Owner(s) shall be fully responsible for care and maintenance of subject project; agree to carry continuous insurance in amounts determined by the City; and shall name the City and its officers, officials, employees, and agents as Additional Insured. Owner(s) acknowledge and agree that the permitted encroachment is subject to removal upon notice from the City. If not removed by owner per City Notice, City may remove and replace same at owner's expense. This document shall be binding on all successors in interest to subject property. All parties to this agreement have executed this instrument on the date shown below their siao.atures. BY: Owner Signature Thomas Heer Print Name 4/29/10 Date CITY OF ARC J � City Engineer CITY OF ARCADIA DEVELOPMENT SERVICES DEPARTMENT HOLD HARMLESS AGREEMENT Proiect in Public Right Of Way 4/29/10 Date (te Wig Owner Signature Carla Heer Print Name DOCUMENT MUST BE SIGNED BY ALL LEGAL OWNERS AND NOTARIZED PRIOR TO CITY APPROVAL Revised 12/99 M CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT �> • .-�g�> >�, > >�S�g��,•�.�5�. S�;t;T. > S�.�i�c >�S�> ei ,�.e�S� ;;T.- �.�.�.�.�>!:�> Jai <�..� -s�.'S . , c�> State of California ,/"� i County of Los 'r`�t \t On 1 i` Date personally appeared aq f (nbefore me, Place Notary Seal Above } (V∎NU\ �∎(\t\O Here Insert Name and Title of t Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) i /are subscribed to the within instrument and acknowledged to me that h'/ske /they executed the same in is /licr /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my nd and offici al. Signature OPTIONAL c Lc). k* e .r Signature of Notary Public Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: \AQ\C 40,r A Document Date: 4(' (\ C c. ©►17 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here c to lv\F t oo c4 1 (Arm) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here ©2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313 -2402 • www.NationalNotary.org Item 85907 Reorder: Call Toll -Free 1- 800 - 876 -6827 4