Right Of Entry/hold Harmless Agreement/duplication Of Benefits Private Property Debris Removal & Demolition Of Unsafe Structures Form 2014
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23/17/14
RIGHT OF ENTRY/HOLD HARMLESS AGREEMENT/DUPLICATION OF BENEFITS
PRIVATE PROPERTY DEBRIS REMOVAL & DEMOLITION OF UNSAFE
STRUCTURES
The massive flooding across Boulder County beginning on September 11, 2013, prompted formal
declarations of disaster emergency by local, state, and federal government officials, and has necessitated
large-scale recovery work on private as well as public property. To participate in this program, the
undersigned hereby gives freely, without coercion, and unconditionally authorizes the County of Boulder in
the State of Colorado, its successors and assigns and its contractors and subcontractors, the United States
of America and its assigns, and its contractors and subcontractors (collectively, the Permitees), to have the
right of access and to enter upon or pass through the property described below (including the interior of
private residential structures and any other structures) at any reasonable time for the purpose of damage
assessment, debris removal, mitigation of imminent threats, and other disaster response activities necessary
to complete the hazard mitigation or recovery work (“Work”) for the property located in Boulder County more
commonly
identified
as
(Address
of
Home,
including
Street,
City,
State,
Zip)____________________________________________
_____________________________________________________________________________________.
This permission will remain in place until the Work is certified complete by the County of Boulder. This
permission does not require me to mark, warn, or mitigate against any flood-related hazards and persons
entering the property assume the risks of such hazards.
RIGHT OF ENTRY: I certify that I am the owner or the owner’s and mortgagor’s authorized agent of the
below described property, and that I have the legal authority to enter into this Agreement. I grant freely and
without coercion the right of access and entry to said property to the Permitees to inspect the property to
assess damages and eligibility for federal program, and for the purpose of performing Work. The undersigned
represents and warrants that he/she/they has/have full power and authority to execute and fully perform the
obligations under this Right-of-Entry without the need for any further action, or that he/she/they is/are duly
appointed agent(s) of the owner and the mortgagor, and that he/she/they has/have full power and authority to
execute and fully perform the obligations under this Right-of-Entry without the need for any further action.
Additionally, the undersigned is fully aware that an individual who fraudulently or willfully misstates any fact in
connection with this agreement shall be subject to a fine as provided under 18 U.S.C. § 1001 or imprisoned
for not more than five years or both.
HOLD HARMLESS: I understand that this Agreement/Permit is not an obligation upon the government to
perform PPDR Work on my property. I agree to hold harmless the Permitees for damages of any type
whatsoever, either to the above-described property and/or any improvements on, or a part of the property, or
to persons situated thereon. I release, discharge, and waive any action, either legal or equitable, that might
arise by reason of any action of the above entities while performing Work. If asked, I will mark sewer lines,
septic tanks, water lines and utilities located on the property.
DUPLICATION OF BENEFITS*: Most homeowner’s insurance policies have coverage to pay for portions of
the PPDR Work. I understand that Federal law (42 U.S. C. 5155 et seq.) requires me to reimburse Boulder
County for the cost of the Work to the extent that such work is covered by my homeowner’s insurance policy.
I also understand that I must provide a copy of the proof/statement of loss from my insurance company, if
any, or a copy of any denial letters received from my insurance company to Boulder County. If I have
received payment, or when I receive payment, for portions of the Work from my insurance company or any
other source, I agree to notify and send payment and proof/statement of loss to Boulder County. I understand
that all disaster-related funding, including for debris removal from private property, is subject to audit.
Continued on Reverse
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