Change Of Contractor Hold Harmless (Page 4 of 4) in pdf

Change Of Contractor Hold Harmless Page 4

Change of Contractor Hold Harmless

(cont’d)

Re: Property located at ___________________________________________________

Permit Number____________________

I, the new Contractor, agree to hold the City Of Miami Beach Building Department, its agents and

authorized personnel, harmless and relieve them from any responsibility or liability for any legal

action or damage, cost or expense (including attorney’s fee) resulting from the change of

contractor on the existing permit. I, furthermore assume responsibility for the entire scope of the

permitted work, specifically all work completed and work to be completed.

I assume

responsibility for the correction, if required, of work performed under the permit for which I am

requesting a change of contractor. If there has been a change of ownership on the property, the

new owner assumes responsibility of notifying the previous owner of his or her intent to transfer

the permit.

____________________

_____________

Qualifier’s Signature

Date

________________________

Printed Name

The person, whose signature is above, deposes that he/she is the qualifier of the above

property.

STATE OF FLORIDA

COUNTY OF DADE

Sworn to and subscribed before me this ____________day of ____________, 2008 by:

_________________________

Printed Name of Applicant

[ ] Personally known to me; or

[ ] Produced Identification ____________________

_________________________

Signature of Notary Public

(Seal)

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Change Of Contractor Hold Harmless Page 4