"Covid-19 Waiver Form - Cdbg-Cv Emergency Assistance Program" - City of Mission, Texas

Covid-19 Waiver Form - Cdbg-Cv Emergency Assistance Program is a legal document that was released by the Community Development Department - City of Mission, Texas - a government authority operating within Texas. The form may be used strictly within City of Mission.

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City of Mission
Community Development Block Grant
Emergency (CDBG-CV)
Rent / Mortgage / Utilities
Assistance Program
Participant Assumption of Risk and Waiver of Liability Relating to
Coronavirus Pandemic COVID-19
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily
assume the risk that I may be exposed to, or infected by COVID-19 by participating under the City of
Mission’s Community Development (CD) Department Programs which includes the Housing Assistance
Program, Emergency Rent / Mortgage / Utilities Assistance Program and any other programs associated
within the dept. and that such exposure or infection may result in personal injury, illness, permanent
disability, and death. I understand exposure to or infection by COVID-19 by participating under the CD
Dept. programs may result from the actions, omissions, or negligence of myself and others, including, but
not limited to, City employees and contractors, subcontractors, or their respective employees.
In no event shall the City or its agents or employees be liable for any claims arising out of the COVID-19
Pandemic. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any
injury to myself including, but not limited to, personal injury, disability, death, illness, damage, loss, claim,
liability, or expense, of any kind, that I may experience or incur in connection with my participating in the
CD Dept. programs. I hereby release, covenant not to sue, discharge, and hold harmless the City of Mission,
its employees, agents, volunteers and representatives, of and from the assistance, including all liabilities,
claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and
agree that this release includes any assistance based on the actions, omissions, or negligence of the City of
Mission, its employees, agents, volunteers and representatives, whether a COVID-19 infection occurs
before, during, or after participation in the City of Mission CD Dept. programs which includes the Housing
Assistance Program, CDBG-CV Emergency Rent/Mortgage/Utilities Assistance Program (CDBG-CV),
and any other programs associated within the dept.
This Agreement shall be governed by the laws of the State of Texas. I agree that the venue for any and all
disputes related to this Agreement shall be Hidalgo County, Texas. For any controversy, claim, or dispute
arising out of or relating to this Agreement, I shall first attempt to informally resolve such controversy, claim, or
dispute with the City. Thereafter, I shall submit in good faith to mediation with the City before commencing a
legal proceeding. Each party shall bear its own costs and expenses, including attorneys’ fees and costs, in
seeking to enforce the terms of this Agreement.
I am at least eighteen years of age and have carefully read and freely signed this Release of Liability
Form. I understand and agree that no oral or written representations can or will alter the contents of this
document. I agree that this agreement shall be governed by the laws of the State of Texas (excluding its conflict
of laws principles).
Signature of Applicant
Print Name
Date
Signature of Co-Applicant
Print Name
Date
City of Mission
Community Development Block Grant
Emergency (CDBG-CV)
Rent / Mortgage / Utilities
Assistance Program
Participant Assumption of Risk and Waiver of Liability Relating to
Coronavirus Pandemic COVID-19
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily
assume the risk that I may be exposed to, or infected by COVID-19 by participating under the City of
Mission’s Community Development (CD) Department Programs which includes the Housing Assistance
Program, Emergency Rent / Mortgage / Utilities Assistance Program and any other programs associated
within the dept. and that such exposure or infection may result in personal injury, illness, permanent
disability, and death. I understand exposure to or infection by COVID-19 by participating under the CD
Dept. programs may result from the actions, omissions, or negligence of myself and others, including, but
not limited to, City employees and contractors, subcontractors, or their respective employees.
In no event shall the City or its agents or employees be liable for any claims arising out of the COVID-19
Pandemic. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any
injury to myself including, but not limited to, personal injury, disability, death, illness, damage, loss, claim,
liability, or expense, of any kind, that I may experience or incur in connection with my participating in the
CD Dept. programs. I hereby release, covenant not to sue, discharge, and hold harmless the City of Mission,
its employees, agents, volunteers and representatives, of and from the assistance, including all liabilities,
claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and
agree that this release includes any assistance based on the actions, omissions, or negligence of the City of
Mission, its employees, agents, volunteers and representatives, whether a COVID-19 infection occurs
before, during, or after participation in the City of Mission CD Dept. programs which includes the Housing
Assistance Program, CDBG-CV Emergency Rent/Mortgage/Utilities Assistance Program (CDBG-CV),
and any other programs associated within the dept.
This Agreement shall be governed by the laws of the State of Texas. I agree that the venue for any and all
disputes related to this Agreement shall be Hidalgo County, Texas. For any controversy, claim, or dispute
arising out of or relating to this Agreement, I shall first attempt to informally resolve such controversy, claim, or
dispute with the City. Thereafter, I shall submit in good faith to mediation with the City before commencing a
legal proceeding. Each party shall bear its own costs and expenses, including attorneys’ fees and costs, in
seeking to enforce the terms of this Agreement.
I am at least eighteen years of age and have carefully read and freely signed this Release of Liability
Form. I understand and agree that no oral or written representations can or will alter the contents of this
document. I agree that this agreement shall be governed by the laws of the State of Texas (excluding its conflict
of laws principles).
Signature of Applicant
Print Name
Date
Signature of Co-Applicant
Print Name
Date