Common use of INDEMNIFICATION AND HOLD HARMLESS AGREEMENT Clause in Contracts

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identification. Signature of Notary Stamp: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature of Notary StampPublic: Commission No: Commission Expires: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑  Insurers – Must have an A.M. Best rating of A or better. ❑  Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑  Policy Terms - Must be current and cover the date(s) of the event or project. ❑  General Liability – Minimum requirements for all contractors and vendors. •  $1,000,000 Each Occurrence •  $100,000 Damage to Rented Premises •  $2,000,000 General Aggregate •  $1,000,000 Products and Completed Operations Aggregate ❑  Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑  Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑  Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑  Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s Apopka, its officers, agents, employees, the organizers, sponsors, activity supervisors, co-sponsoring organizations and employees participants from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identification. Signature of Notary Stamp: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defendThe USER named above hereby executes in favor of the CITY and its officers, indemnify employees, agents and attorneys, this Indemnification and Hold Harmless Agreement, and agrees on his/her/its own behalf and on behalf of any and all derivative claimants and legal representatives of any and all types, nature, or relationships, to forever release, discharge, and hold harmless CITY, and the City of Apopka and all of City’s officers, employees, agents, and employees attorneys thereof, and to indemnify CITY and its officers employees, agents, and attorneys thereof, in both their official and individual capacities, from any and against all liability, claims, liabilitydamages, loss and expenseexpenses, including reasonable costsall attorney's fees and any possible litigation costs through pre-trial, collection expensestrial and any and all appeals, attorneys’ feesresulting from or arising out of the use of the above-specified facility. Date: Date: Witness: USER: Signature Signature (Print name and address) (Print name, title, if any and address) CITY OF ROCKLEDGE FACILITY USE - FOOD WAIVER REQUEST This food waiver request must be completed in its entirety. Incomplete requests will be returned to the Organization/Applicant (the "Organization") and may delay approval. Organization/Applicant's Name: Address: Contact Person: Phone# EVENT DETAILS Type/Name of Event: Description of Event: City Facility Requested: Date of Event: CATERED FOOD FOR EVENTS A licensed and insured caterer MUST be used for all food SERVED at your event. A copy of your insured caterer's license must be on file ONE (1) month prior to your event. If a caterer is not used, the food must be served from furnished trays (Publix, etc.). However, the City of Rockledge (the "City") recognizes that occasionally events have special circumstances in which catering options do not meet the needs of the event. These special circumstances may include certain non-profit charity functions running fund raising events and private groups having a "potluck" party wherein the group members bring in food to share with other group members. In such cases, the City MAY permit the Organization to serve Non-Catered Food (where individual members of the Organization brings in a food item.) Under no circumstances will the City allow events consisting of greater than one hundred (100) people to serve Non-Catered Food. If the City allows the Organization to provide Non-Catered Food, the Organization hereby warrants and confirms that the information contained within, to the best of the Organization's knowledge, is true and correct, and court costs further certified that the Organization and each individual bringing in Non-Catered food has read the USDFA food and safety inspection service flier, 7 Food Safety Steps for Successful Community Meals, which may arise because of accompanies this form. Furthermore, if the negligence City allows the Organization to provide Non-Catered Food, the Organization agrees to indemnify the City (whether active or passiveas described below). UNDER NO CIRCUMSTANCES MAY THE ORGANIZATION BRING IN ALCOHOL, misconductOTHER THAN AS DESCRIBED IN THE CITY OF ROCKLEDGE FACILITY USE APPLICATION AND AGREEMENT. NON-CATERED FOOD INDEMNIFICATION/HOLD HARMLESS AGREEMENT The Organization agrees to and will at all times indemnify, or other faultsave and hold the City, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, and its officers, employees, attorneys and agents or employees in performance or non-performance of its obligations under the Agreementthrough all appellate proceedings harmless from any and all liability, including but not limited toclaims, automobile negligencedemands, foodborne illness negligencedisputes, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification damages, costs, attorney's fees and hold harmless clauseexpenses, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided incurred by the City and its officers, employees, attorneys and agents as a result, directly or indirectly, resulting from the preparation and/or service of any food or beverage at the event by the Organization and its members, guests, visitors, spectators, and participants. By signing below, the Organization understands and agrees to use the information included in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the 7 Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Safety Steps for Successful Community Means Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identification. Signature of Notary StampSignature: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.Event Type: Date: Accepting Staff Signature: Date:

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature of Notary StampPublic: Commission No: Commission Expires: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 2,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature Notary Public: Commission No: Commission Expires: Insurance Requirements General Events and Activities The original insurance certificate and all extensions to the insurance certificate should be sent to: City of Notary StampApopka, Human Resources/Risk Management, 000 Xxxx Xxxx Xxxxxx, Xxxxxx, XX 00000 or E-mailed to xxxxxxxxxxxxxx@xxxxxx.xxx Phone: 000-000-0000 Certificate Holder: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the These minimum requirements are based on average exposure eventsevents and activities. Events or activities that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defendThe APPLICANT named above hereby executes in favor of the CITY and its officers, indemnify employees, agents and attorneys, this Indemnification and Hold Harmless Agreement, and agrees on his/her/its own behalf and on behalf of any and all derivative claimants and legal representatives of any and all types, nature, or relationships, to forever release, discharge, and hold harmless CITY, and the City of Apopka and all of City’s officers, employees, agents, and employees attorneys thereof, and to indemnify CITY and its officers employees, agents, and attorneys thereof, in both their official and individual capacities, from any and against all liability, claims, liabilitydamages, loss and expenseexpenses, including reasonable costsall attorney's fees and any possible litigation costs through pre-trial, collection expensestrial and any and all appeals, attorneys’ feesresulting from or arising out of the use of the above-specified facility. Date: Date: Witness: APPLICANT: Signature Signature (Print name and address) (Print name, title, if any and address) CITY OF ROCKLEDGE FACILITY USE - FOOD WAIVER REQUEST This food waiver request must be completed in its entirety. Incomplete requests will be returned to the Organization/Applicant (the "Organization") and may delay approval. Organization/Applicant's Name: Address: Contact Person: Phone# EVENT DETAILS Type/Name of Event: Description of Event: City Facility Requested: Date of Event: CATERED FOOD FOR EVENTS A licensed and insured caterer MUST be used for all food SERVED at your event. A copy of your caterer's license and insurance must be on file thirty (30) days prior to your event. If a caterer is not used, the food must be served from furnished trays (Publix, etc.). However, the City of Rockledge (the "City") recognizes that occasionally events have special circumstances in which catering options do not meet the needs of the event. These special circumstances may include certain non-profit charity functions, fundraising events, and court costs which may arise because private groups having a "potluck" party wherein the group members bring in food to share with other group members. In such cases, the City MAY permit the Organization to serve non-catered food (where individual members of the negligence Organization brings in a food item). Under no circumstances will the City allow events consisting of greater than one hundred (whether active or passive)100) people to serve non-catered food. If the City allows the Organization to provide non-catered food, misconductthe Organization hereby warrants and confirms that the information contained within, or other fault, in whole or in part (whether joint, concurrent, or contributing), to the best of the Organization's knowledge, is true and correct, and further certified that the Organization and each individual bringing in non-catered food has read the USDFA food and safety inspection service flier, 7 Food VendorSafety Steps for Successful Community Meals, which accompanies this form. Furthermore, if the City allows the Organization to provide non-catered food, the Organization agrees to indemnify the City (as described below). UNDER NO CIRCUMSTANCES MAY THE ORGANIZATION BRING IN ALCOHOL, OTHER THAN AS DESCRIBED IN THE CITY OF ROCKLEDGE FACILITY USE APPLICATION AGREEMENT. NON-CATERED FOOD INDEMNIFICATION/HOLD HARMLESS AGREEMENT The Organization agrees to and will at all times indemnify, save and hold the City, and its officers, employees, attorneys and agents or employees in performance or non-performance of its obligations under the Agreementthrough all appellate proceedings harmless from any and all liability, including but not limited toclaims, automobile negligencedemands, foodborne illness negligencedisputes, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification damages, costs, attorney's fees and hold harmless clauseexpenses, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided incurred by the City and its officers, employees, attorneys and agents as a result, directly or indirectly, resulting from the preparation and/or service of any food or beverage at the event by the organization and its members, guests, visitors, spectators, and participants. By signing below, the organization understands and agrees to use the information included in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the 7 Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Safety Steps for Successful Community Means Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identification. Signature of Notary StampSignature: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.Event Type: Date: Accepting Staff Signature: Date:

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defendThe APPLICANT named above hereby executes in favor of the CITY and its officers, indemnify employees, agents and attorneys, this Indemnification and Hold Harmless Agreement, and agrees on his/her/its own behalf and on behalf of any and all derivative claimants and legal representatives of any and all types, nature, or relationships, to forever release, discharge, and hold harmless CITY, and the City of Apopka and all of City’s officers, employees, agents, and employees attorneys thereof, and to indemnify CITY and its officers employees, agents, and attorneys thereof, in both their official and individual capacities, from any and against all liability, claims, liabilitydamages, loss and expenseexpenses, including reasonable costsall attorney's fees and any possible litigation costs through pre-trial, collection expensestrial and any and all appeals, attorneys’ feesresulting from or arising out of the use of the above-specified facility. Date: Date: Witness: APPLICANT: Signature Signature (Print name and address) (Print name, title, if any and address) CITY OF ROCKLEDGE FACILITY USE - FOOD WAIVER REQUEST‌‌‌ This food waiver request must be completed in its entirety. Incomplete requests will be returned to the Organization/Applicant (the "Organization") and may delay approval. Organization/Applicant's Name: Address: Contact Person: Phone# EVENT DETAILS Type/Name of Event: Description of Event: City Facility Requested: Date of Event: CATERED FOOD FOR EVENTS A licensed and insured caterer MUST be used for all food SERVED at your event. A copy of your caterer's license and insurance must be on file thirty (30) days prior to your event. If a caterer is not used, the food must be served from furnished trays (Publix, etc.). However, the City of Rockledge (the "City") recognizes that occasionally events have special circumstances in which catering options do not meet the needs of the event. These special circumstances may include certain non-profit charity functions, fundraising events, and court costs which may arise because private groups having a "potluck" party wherein the group members bring in food to share with other group members. In such cases, the City MAY permit the Organization to serve non-catered food (where individual members of the negligence Organization brings in a food item). Under no circumstances will the City allow events consisting of greater than one hundred (whether active or passive)100) people to serve non-catered food. If the City allows the Organization to provide non-catered food, misconductthe Organization hereby warrants and confirms that the information contained within, or other fault, in whole or in part (whether joint, concurrent, or contributing), to the best of the Organization's knowledge, is true and correct, and further certified that the Organization and each individual bringing in non-catered food has read the USDFA food and safety inspection service flier, 7 Food VendorSafety Steps for Successful Community Meals, which accompanies this form. Furthermore, if the City allows the Organization to provide non-catered food, the Organization agrees to indemnify the City (as described below). UNDER NO CIRCUMSTANCES MAY THE ORGANIZATION BRING IN ALCOHOL, OTHER THAN AS DESCRIBED IN THE CITY OF ROCKLEDGE FACILITY USE APPLICATION AGREEMENT. NON-CATERED FOOD INDEMNIFICATION/HOLD HARMLESS AGREEMENT The Organization agrees to and will at all times indemnify, save and hold the City, and its officers, employees, attorneys and agents or employees in performance or non-performance of its obligations under the Agreementthrough all appellate proceedings harmless from any and all liability, including but not limited toclaims, automobile negligencedemands, foodborne illness negligencedisputes, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification damages, costs, attorney's fees and hold harmless clauseexpenses, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided incurred by the City and its officers, employees, attorneys and agents as a result, directly or indirectly, resulting from the preparation and/or service of any food or beverage at the event by the organization and its members, guests, visitors, spectators, and participants. By signing below, the organization understands and agrees to use the information included in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the 7 Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Safety Steps for Successful Community Means Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identification. Signature of Notary StampSignature: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.Event Type: Date: Accepting Staff Signature: Date:

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature of Notary StampPublic: Commission No: Commission Expires: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the minimum requirements based on average exposure events. Events that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑  Insurers – Must have an A.M. Best rating of A or better. ❑  Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑  Policy Terms - Must be current and cover the date(s) of the event or project. ❑  General Liability – Minimum requirements for all contractors and vendors. •  $1,000,000 Each Occurrence •  $100,000 Damage to Rented Premises •  $2,000,000 General Aggregate •  $1,000,000 2,000,000 Products and Completed Operations Aggregate ❑  Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑  Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑  Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑  Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature Notary Public: Commission No: Commission Expires: Insurance Requirements General Events and Activities The original insurance certificate and all extensions to the insurance certificate should be sent to: City of Notary StampApopka, Human Resources/Risk Management, 000 Xxxx Xxxx Xxxxxx, Xxxxxx, XX 00000 or E-mailed to xxxxxxxxxxxxxx@xxxxxx.xxx Phone: 000-000-0000 Certificate Holder: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the These minimum requirements are based on average exposure eventsevents and activities. Events or activities that involve high or unusual hazards may require higher limits of coverage. The City of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 (Businesses employing more than four employees or in compliance with applicable state and federal laws) ❑ Liquor Liability – Minimum Limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured status, respective of General Liability, must include Completed Operations.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. Food Vendor shall defend, indemnify and hold harmless the City of Apopka and all of City’s officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys’ fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of the Food Vendor, its officers, agents or employees in performance or non-performance of its obligations under the Agreement, including but not limited to, automobile negligence, foodborne illness negligence, or other claims and/or suits. Food vendor recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve the Food Vendor of its liability and obligation to defend, hold harmless and indemnify the City as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Apopka’s liability beyond that provided in section 768.28, Florida Statutes. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. Printed Name of Applicant: Signature of Applicant: Title of Applicant: Vendor/Business Name: STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this day of , 20 , by , and who is personally known to me or who has produced as identificationidentification and who did (did not) take an oath. Signature Notary Public: Commission No: Commission Expires: Insurance Requirements General Events and Activities The original insurance certificate and all extensions to the insurance certificate should be sent to: City of Notary StampApopka, Human Resources/Risk Management, 000 Xxxx Xxxx Xxxxxx, Xxxxxx, XX 00000 or E-mailed to xxxxxxxxxxxxxx@xxxxxx.xxx Phone: 000-000-0000 Certificate Holder: City of Apopka Certificate of Insurance Checklist General Events and Activities Please note that this checklist is meant to represent the These minimum requirements are based on average exposure eventsevents and activities. Events or activities that involve high or unusual hazards may require higher limits of coverage. The City W orkers’ Compensation: If the business falls under the State of Apopka reserves the right to require additional coverages, waive certain requirements, require higher limits or accept lower limits on a case by case basis after the review of the associated risk. ❑ Insurers – Must have an A.M. Best rating of A or better. ❑ Certificate Holder – City of Apopka, 000 X Xxxx Xxxxxx, Xxxxxx, XX 00000 ❑ Policy Terms - Must be current and cover the date(s) of the event or project. ❑ General Liability – Minimum requirements for all contractors and vendors. • $1,000,000 Each Occurrence • $100,000 Damage to Rented Premises • $2,000,000 General Aggregate • $1,000,000 Products and Completed Operations Aggregate ❑ Automobile Liability – Combined Single Limit of $300,000 (Required when vehicle functions as the workplace or is used to perform contracted work.) ❑ Florida Workers’ Compensation – Minimum limits in the amount of $1,000,000/$1,000,000/$1,000,000 Law (Businesses employing more than four employees or 4 employees), coverage shall be provided for all employees. The coverage shall be for statutory limits in compliance with the applicable state and federal laws) ❑ Liquor . The policy must include Employers’ Liability – Minimum Limit with a limit of $1,000,000 (If Applicable) ❑ Additional Insured – The City of Apopka is to be included as a named additional insured on all policies except Workers’ Compensation. Additional Insured statuseach accident, respective of General Liability$1,000,000 each employee, must include Completed Operations$1,000,000 policy limit for disease.