Sample License And Indemnity Agreement - City Of Cape Girardeau Page 3

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IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed this
day of _________________.
Property Owner
Property Owner
Scott Meyer, City Manager
ATTEST:
__________________________
Gayle L. Conrad, City Clerk
STATE OF MISSOURI
)
) SS.
COUNTY OF CAPE GIRARDEAU
)
On this
day of
, 20
, before me personally appeared
, to me known to be the persons described in and who executed
the foregoing instrument, and acknowledged that they executed the same as their free act and
deed.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal
at my office in said County and State the day and year first above written.
My Commission Expires:
-3-

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