Waiver of All Claims for Damage to Private StreetsM
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").
- �55oC�i
s7 �j l��iv.,(,I�o oG�.'�Z (hereinafter 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 gutters, constructed within common 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 equipment
upon the Association's privately owned streets.
Inasmuch as there is always the possibility that 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
indemnify 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 � day of t, / tT 20 &
a .
Name of Association:
VERIFICATION
duly sworn,
By:
(name)
(title)
�s�oG
oath, verify that I am the duly elected
e been duly author' ed execute the
above Waiver of all Claims for Damage to Private Streets on behalf o'ithe associati
(printed name)
STATE OF KANSAS, COUNTY OF SALINE, ss:
Signed and sworn to before me onLZ 2oVz,, L--ZI Cam. /j
Notary Public
Association Address:
�, Street & Pa r Off�e Box
Ciry, State & Zip Code CATHY BOLL
FMYAPpt. ry Public - State of Kansas
xpir es ZQ-