Fillable Printable Free Hold Harmless Agreement
Fillable Printable Free Hold Harmless Agreement
Free Hold Harmless Agreement
HOLD HARMLESS AGREEMENT FORM #1
AGREEMENT
THIS AGREEMENT, made and entered into this day of , 20
by and between,
(Hereinafter the “Owner”), the owner of certain real property, more particularly described
as
as recorded in Deed Book at Page , and the Board of Supervisors of
Fairfax County, Virginia (hereinafter the “County”),
Witnesseth that:
WHEREAS, part of the above-described property of the Owner is located within the
flood plain as designated and
adopted by the County; and
WHEREAS, the County has advised and warned the Owner of the location and existence of the
flood plain; and
WHEREAS, the Owner nonetheless wishes and elects to build at its own risk within that flood
plain:
NOW, THEREFORE, in consideration of the mutual covenants herein contained and other good
and valuable consideration, the parties hereto agree as follows:
1.
� T
he County hereby permits the Owner to construct or cause to be �
constructed � on the above-
described property within the flood plain as shown
on Attachment A.
2.
� T
he Owner, its executors, administrators, assigns and any other successors-in-
interest shall indemnify and hold the County, its agents, and employees harmless
for any and all damages, accidents, casualties, injuries, costs, charges, liabilities,
occurrences or claims which might arise or be asserted against the County by
reason of the construction, existence, presence of flooding of the
or any appurtenances thereto.
In the event a claim is asserted against the County or its agents or employees, the
County shall promptly notify the Owner, and the Owner or its successors-in-interest
shall defend such claim or suit at its own expense. If any judgment or claims are
allowed against the County or its agents or employees, the Owner or its
successors-in-interest shall pay all costs and expenses in connection therewith.
3. � It is expressly understood and agreed that the maintenance of the
shall be solely the responsibility of the Owner or its successors in interests.
4.
� T
his Agreement shall constitute a covenant real running with the land and shall be
recorded amongst the land records of Fairfax County, Virginia.
Witnesses
The following signatures and seals:
TAX MAP #
PROJECT #
Updated Feb 2015
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I
I
OWNER and SEAL (Please print name and title):
OWNER and SEAL (Please print name and title):
FAIRFAX
COUNTY,
VIRGINIA
BOARD
OF
SUPERVISORS
By
Director, Site Development and Inspections Division, Land Development Services,
Department of Public Works and Environmental Services
STATE OF: COUNTY OF:
a Notary Public in and for the County and State aforesaid,
Whose commission expires on the
do hereby certify that
foregoing Agreement bearing date of the
has acknowledged the same before me in my said County and State.
GIVEN UNDER MY HAND this of
of
of
20
name(s)
20
is/are signed to the
20
Notary Public
STATE OF: COUNTY OF:
a Notary Public in and for the County and State aforesaid,
Whose commission expires on the
do hereby certify that
foregoing Agreement bearing date of the
has acknowledged the same before me in my said County and State.
GIVEN UNDER MY HAND this of
of
of
20
name(s)
20
is/are signed to the
20
Notary Public
TAX MAP #
PROJECT #
Updated Feb 2015
P
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