1. REQUESTEE DETAILS
- 1.1 Full Name: Liam Binnie
1.2 Date of Birth: 10/MAR/1998
1.3 Phone Number: 230-8815
1.4 Please attach a photocopy of your driver's license 1.5 Please attach a copy of your event planning license, obtained via City Hall:- N/A as we are a government funded company.
2. EVENT DETAILS
- 2.1 Event location: Terminal, Just off Buccaneer way
2.2 Event date: 05/May/2024
2.3 Start time (( UTC )): 20:00
2.4 Estimated finish time (( UTC )): 22:00
2.5 Estimated number of participants: 25
2.6 Details of planned event (Please provide a map with planned road closures, if they are required, an example can be seen here): 2.7 Is someone BLS certified required for this event? If so, please inform us of the names of the individuals who will be in attendance:- [x] Yes, we have one or more individuals that are BLS certified.
[] No, we do not have any individuals that are BLS certified.
If yes, please list the individual(s):
Liam Binnie
Deano Jackson
- [x] Yes, we have one or more individuals that are BLS certified.
3. INDEMINIFICATION AND HOLD HARMLESS AGREEMENT
In consideration of the granting of the road closure permit, except for the active negligence or willful misconduct of City or any of its Boards, Officers, Agents, Employees, Assigns, and Successors in Interest, the permittee undertakes and agrees to defend, indemnify, and hold harmless City and any and all of City's Boards, Officers, Agents, Employees, Assigns, and Successors in Interest, from and against all suits and causes of actions, claims, losses, demands, and expenses, including, but not limited to, attorney's fees and costs of litigation, damage or liability of any nature whatsoever, for death or injury to any person, including permittee's employees and agents, or damage or destruction of any property of either party hereto or of third parties, arising in any manner by reason of the negligent acts, errors, omissions or willful misconduct incident to the performance of this Agreement on the part of the permittee.
- 3.1 Signature:
3.2 Date Signed: 12/APR/2024