Waiver for Damage to Private Streets
04/30/2008 08:36 FAX 1 785 309 5750
GENERAL SERVICES OFFICE
~001
WAIVER OF ALL CLAIMS
FOR DAMAGE TO PRIVATE STREETS
The City of Salina, Kansas, is a City of the First Class within the State of Kansas (hereinafter referred to as
"the City').
"'"'Co- J'.", Mot \ ,It~ <<, \-\ CI.vJ~~ereinaftet' referred to as "the Association") is a homeowners association
within the corporate limits of the City of Salina, Kansas, organized as a Kansas
The Association owns private streets, including curbs and guttef$, constructed within comlnon area owned
by the Association (the "privately owned streets").
The City, upon request of the Association, provides a variety of City services to the Association and its
homeowner members, including, without limitation:
Trash pick up
Water and sanitary sewer utility installation, repair, and maintenance
Limb removal resulting from community-wide storm damage
Fall leaf collection
To deliver the requested City services often requires the operation of vehicles, machinery and eq~ipmcnt
upon the Association's privately owned streets.
Inasmuch as there is always the possibility thal the privately owned streets, including curbs and gutters,
may suffer damage 'from the vehicles, equipment and machinery utilized by the City to deliver the requested services
and in partial consideration of the services to be provided by the City to the Association and its members, the
undersigned does hereby agree, on behalf of the Association and its members to waive, release, hold harmless and
indemnity the City for all claims for damage or loss to the privately owned streets, including curbs and gutters, that
may be caused by any act, or failure to act, of the City, its officers, agents, or employees arising out of the City's use
of the privately owned streets to provide the requested City services to the Association or any member. In executing
this waiver and release, the undersigned, on behalf of the Association and its members, acknowledges and agrees
that the type of vehicles, machinery and equipment to be utilized by the City in the delivery of services to the
Association is a determination totally at the discretion of the City, its officers, agents or employees.
Dated this ;0 day of Apri\ 200f>
Name of Association:
t'lt..r\t. ~. ~ t1eh'~ e.. l+O~~5
~~9~
~f'l\' OWN-V''' (title)
VERIFICATION
1, tJ~'f ~ER.... , having been duly sworn, on oath. verify that I am the duly elect~d
}j ~+A-~'1 ~ of ,$J:lll1ve Q:v. KI'l NMS and that ( have been duly authorized to execute the
above Waiver of' all Claims for Damage to Privl1te Streets on behalf of the association.
N A 1\JlU.j Le A-in~1:...
(printed name)
STATE OF KANSAS, COUNTY OF SALINE, S5:
Signed and sworn to before me on L\-- 00 - ,200] by ~.-.e~ ~
Association Address:
\ 0 0 M 0 ~+ B^"" \,J\,.V'A.
Street & Post Office 80x
SA, H .vI.., ~":> (p 1 lot 0'
City, Slate & Zip Code
Notary Public::
t\. NANCY J, LEAMER
~ Notary Public. State 01 Kansas
My Appl. ExpiresS-~i . 10