Special Event Checklist (Page 7 of 8) in pdf

Special Event Checklist Page 7

Revised January 22, 2015

Addendum #5 (Submit if applicable)

Indemnification Agreement

It is the specific and express intent of the Indemnifier named below that in the event:

_________________________________________________________________

Hotel or Event Facility or 3

Party Bartender Name/Company

(Indemnifier) should either directly or indirectly, cause damage, loss, destruction, liability or

claims against the Omega Psi Phi Fraternity, Inc., Indemnifier agrees to defend, indemnify and

hold harmless the Omega Psi Phi Fraternity, Inc. from any and all obligations, liabilities, causes

of actions, lawsuits, damages, assessments, including legal fees, and court costs as a result of

said Indemnifier’s intentional actions or negligence.

This indemnification agreement shall be enforceable as a separate cause of action in the event

necessary.

Authorized

Signature:__________________________________________________________

Date:______________________________________________

Printed Name and

Title:_____________________________________________________________

Contact Information:

Event:___________________________________________________

Facility/Bartending Svc.:____________________________________________

Name:

_______________________________________________

Address:

_______________________________________________

City/State/Zip

_______________________________________________

Phone Number:

_______________________________________________

Email:

_______________________________________________

* Required Signatures – Checklist will be returned and not processed if all required signatures are not listed.

Special Event Checklist Page 7