Citizen’s Fire Company #1
(717)-838-1421
(717)-838-3098 Fax
In consideration of the leasing of the premises described below (the ”premises”) by Citizen’s Fire Company #1 (the “Fire Company) to the Undersigned for itself, it’s heir, executors, administrators, successors, and assigns (as the context may require) hereby releases, acquits, and forever discharges the Fire Company, its officers, directors, agents, members, servants, and employees (collectively, the “Fire Company Parties”) from any and all suits, actions, compensation, consequential damage, punitive damage, or any other thing whatsoever on account of, or in any way growing out of ,any and all property damage, personal injuries, illness, death or any other thing resulting or to result from any occurrence or accident that may happen as a result of or arise out of leasing or use of the Premises (the “Premises Claims”)
The Undersigned hereby agrees to indemnify, defend and hold harmless the Fire Company Parties against Premises Claims brought by any person or entity.
The Undersigned shall provide the Fire Company with a certificate of insurance evidencing in force general liability insurance with coverage limits of at least $1,000,000 per occurrence.
This Agreement and Release shall not be pleaded by the Undersigned as a bar to any claim or suit, nor asserted as an admission of liability against the persons, firms, and corporations hereby released.
This Agreement and Release contains the entire agreement between the parties hereto, and it terms are contractual and not mere recital. Any reference herein to masculine, feminine or neuter gender shall be deemed to include any gender, which the context of such reference require.
The Undersigned hereby executes and delivers this Agreement and Release to include the Fire Company of the lease the Premises to the Undersigned.
The Premises described as follows:
___________________________ ________________________________
Witness Authorized Signature
Date:_______________________ ________________________________
Undersigned Name Printed
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Undersigned’s Address