"Special Events Indemnity Agreement Form" - City of Miami Beach, Florida

Special Events Indemnity Agreement Form is a legal document that was released by the Florida Department of State (Secretary of State) - a government authority operating within Florida. The form may be used strictly within City of Miami Beach.

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Download "Special Events Indemnity Agreement Form" - City of Miami Beach, Florida

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CITY OF MIAMI BEACH
OFFICE OF FILM AND EVENT PRODUCTION MANAGEMENT
INDEMNITY AGREEMENT
FOR
SPECIAL EVENTS
(Applicant must not leave any sections blank; document must be completed and executed)
This Indemnity Agreement made this
day of
, 20
,
by and between the City of Miami Beach, Florida ("City") and
a.
(Legal Name of Entity/hereinafter referred to as “Indemnitor”); should mirror legal name
exactly as it appears on the Certificate of Insurance.
b.
For use of the following City-owned and/or other property:
(hereinafter referred to as the “Premises”); please list name and physical address.
c.
For the following Special Event (name of event):
,
d.
For a term commencing on
, and ending on
(“the Term”); inclusive of load-in and load-out dates.
W I T N E S S E T H:
1. Exculpation and Indemnification Clause: Indemnitor agrees that it will indemnify, hold and save the
City of Miami Beach, Florida, its officers, agents, contractors and employees (collectively, also
referred to herein as the City), whole and harmless and, at City's option, defend same from and
against all claims, demands, actions, damages, loss, costs, liabilities, expenses and judgments of any
nature recovered from or asserted against City on account of injury or damage to person or property
to the extent that any such damage or injury may be incident to, arise out of, or be caused, either
proximately or remotely, wholly or in part, by an act, omission, negligence or misconduct on the part
of Indemnitor or any of its agents, servants, employees, contractors, patrons, guests, licensees or
invitees or of any other person entering upon the Premises used hereunder with the express or
implied invitation or permission of Indemnitor, or when any such injury or damage is the result,
proximate or remote, of the violation by Indemnitor or any of its agents, servants, employees,
contractors, patrons, guests, licensees or invitees of any law, ordinance or governmental order of any
kind, or when any such injury or damage may in any other way arise from or out of the use by
Indemnitor, its agents, servants, employees, contractors, patrons, guests, licensees or invitees of the
Premises used hereunder. Indemnitor covenants and agrees that in case the City shall be made party
to any litigation against Indemnitor, or in any litigation commenced by a party against any party other
than Indemnitor relating to this Agreement or to the Premises used hereunder, then Indemnitor shall
and will pay all costs and expenses, including reasonable attorney's fees and court costs, incurred by
or imposed upon City by virtue of any such litigation.
These terms of indemnification shall be
effective unless such damage or injury may result from the sole negligence, gross negligence or
willful misconduct of City. This indemnification shall survive termination or expiration of this
Agreement.
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CITY OF MIAMI BEACH
OFFICE OF FILM AND EVENT PRODUCTION MANAGEMENT
INDEMNITY AGREEMENT
FOR
SPECIAL EVENTS
(Applicant must not leave any sections blank; document must be completed and executed)
This Indemnity Agreement made this
day of
, 20
,
by and between the City of Miami Beach, Florida ("City") and
a.
(Legal Name of Entity/hereinafter referred to as “Indemnitor”); should mirror legal name
exactly as it appears on the Certificate of Insurance.
b.
For use of the following City-owned and/or other property:
(hereinafter referred to as the “Premises”); please list name and physical address.
c.
For the following Special Event (name of event):
,
d.
For a term commencing on
, and ending on
(“the Term”); inclusive of load-in and load-out dates.
W I T N E S S E T H:
1. Exculpation and Indemnification Clause: Indemnitor agrees that it will indemnify, hold and save the
City of Miami Beach, Florida, its officers, agents, contractors and employees (collectively, also
referred to herein as the City), whole and harmless and, at City's option, defend same from and
against all claims, demands, actions, damages, loss, costs, liabilities, expenses and judgments of any
nature recovered from or asserted against City on account of injury or damage to person or property
to the extent that any such damage or injury may be incident to, arise out of, or be caused, either
proximately or remotely, wholly or in part, by an act, omission, negligence or misconduct on the part
of Indemnitor or any of its agents, servants, employees, contractors, patrons, guests, licensees or
invitees or of any other person entering upon the Premises used hereunder with the express or
implied invitation or permission of Indemnitor, or when any such injury or damage is the result,
proximate or remote, of the violation by Indemnitor or any of its agents, servants, employees,
contractors, patrons, guests, licensees or invitees of any law, ordinance or governmental order of any
kind, or when any such injury or damage may in any other way arise from or out of the use by
Indemnitor, its agents, servants, employees, contractors, patrons, guests, licensees or invitees of the
Premises used hereunder. Indemnitor covenants and agrees that in case the City shall be made party
to any litigation against Indemnitor, or in any litigation commenced by a party against any party other
than Indemnitor relating to this Agreement or to the Premises used hereunder, then Indemnitor shall
and will pay all costs and expenses, including reasonable attorney's fees and court costs, incurred by
or imposed upon City by virtue of any such litigation.
These terms of indemnification shall be
effective unless such damage or injury may result from the sole negligence, gross negligence or
willful misconduct of City. This indemnification shall survive termination or expiration of this
Agreement.
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2. Responsibility for Damage: If the Premises or any portion thereof, or any structure attached thereto,
or any equipment, fixture, or other item contained therein shall be destroyed, damaged, marred,
altered, or physically changed during the Term in any manner whatsoever, then Indemnitor shall be
responsible. Indemnitor is to properly care for all equipment entrusted to Indemnitor during the term of
this Agreement and all such equipment so entrusted which is lost, stolen, or disappeared shall be the
sole responsibility of Indemnitor and Indemnitor shall pay the full replacement cost thereof to City.
3. Ordinances and Regulations: Indemnitor shall comply with all applicable laws, statutes and
ordinances and all rules and requirements of the City of Miami Beach. Miami-Dade County, State of
Florida, and the United States Government, as applicable, including, without limitation the City of
Miami Beach Special Event Guidelines, as same may be amended from time to time. Indemnitor shall
not admit to the Premises a larger number of persons than the total number designated by the
appropriate City Department the number that can safely and freely move about.
4. Insurance: Indemnitor shall, as a condition precedent to being allowed to conduct the Special Event
hereunder, deliver to the City of Miami Beach, Office of Film & Event Production Management,
located at City Hall, 1700 Convention Center Drive, Miami Beach, Florida 33139:
a) Certificate(s) of insurance providing for Comprehensive General Liability insurance with a
minimum coverage of one million ($1,000,000.00) dollars per occurrence for bodily injury,
death, property damage, and personal injury. The policy must also include coverage for
contractual liability. If the Indemnitor’s activities involve the service and/ or sale of alcohol,
then liquor liability in the same amount is also required. The aforestated required liability
insurance must name the City of Miami Beach as an additional insured and certificate
holder with full mailing address thereon.
b) Indemnitor shall also provide poof of Worker’s Compensation Insurance if required by Florida
law.
Indemnitor must check one of the following boxes with regard to Worker’s
Compensation:
Indemnitor is required to carry Worker’s Compensation as required by Florida law
and agrees to provide evidence of such coverage.
Indemnitor is not required to carry Worker’s Compensation under Florida law.
c) The above liability and Worker’s Compensation insurance (if required under Florida law)
coverage shall be issued by an insurance company duly authorized to do business in the
State of Florida and rated B+ VI or better per A.M. Best’s Key rating Guide, latest edition.
Indemnitor warrants and represents that it has notified its insurance agent of the contents of
this Agreement, and has supplied the agent with a copy.
d) It is understood and agreed that all coverage provided by the Indemnitor is primary to any
insurance or self-insurance program the City has and the Indemnitor and its insurance shall
have no right of recovery or subrogation against the City.
7. Other Terms and Conditions: The Indemnitor shall provide, at Indemnitor's sole cost and expense,
off-duty City of Miami Beach Police Officers and off-duty City of Miami Beach Firefighters and/or City
of Miami Beach Rescue Service, as required by the City of Miami Beach Police and Fire
Departments.
[REMAINDER OF PAGE LEFT INTENTIONALLY BLANK]
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IN WITNESS WHEREOF, the Indemnitor by and through its authorized representative, has executed this
Agreement this
day of
, 20
,
(this date must match the date on the notarization section below).
The undersigned hereby warrants, represents and certifies to the City of Miami Beach that he/she is the
lawful representative of Indemnitor and that he/she has the authority to execute this Agreement by and on
behalf of Indemnitor and bind Indemnitor to the terms and conditions herein.
INDEMNITOR:
(Print name of Legal Entity/Indemnitor) should mirror legal name exactly
as it appears on the Certificate of Insurance.
BY:
(Signature of Indemnitor and/or its authorized representative)
(Print name and title of person signing)
STATE OF FLORIDA
)
)ss:
COUNTY OF MIAMI-DADE
)
The foregoing instrument was acknowledged before me this
day of
,20
, by
(Name), as
(Title)
of
(Name
of
Legal
Entity/Indemnitor), a
corporation (state of incorporation). He/she is
personally known to me or has produced
as identification.
Notary Public
Name of Notary typed or printed
My Commission Expires:
Form Approved
Legal Department
By:
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