Organization Corporation Hold Harmless Agreement (Page 2 of 2) in pdf

- Hold Harmless Agreement Page 2 -

If a Corporation, Corporate Acknowledgement is to be attached hereto:

Address of Organization or Corporation and Contact Person:

____________________________________________________________________________________

(Organization/Corporation Name)

____________________________________________________________________________________

(Mailing Address)

____________________________________________________________________________________

(Individual’s Name/Title on Behalf of Organization/Corporation)

Work Telephone: ___________________________ Home Telephone: ___________________________

Email: ____________________________________ Fax: _____________________________________

Date: ____________________________________

and,

Signature on behalf of the Township of Bedminster

____________________________________________________________________________________

Township of Bedminster Authorized Representative

Title: _____________________________________ Date: ____________________________________

For use with Corporations only – provide this only if entity using the premises

is a corporation.

Corporate Acknowledgement

State of New Jersey, County of ____________________________SS:________________

I hereby certify that on ____________________, 20______, _________________________

(Month/Day)

(Year)

(Name of Individual)

personally came before me and this person acknowledged under oath, to my satisfaction,

that:

a. this person is the _______________________ of ___________________________,

(Title)

(Corporation Name)

the corporation named in the attached document.

b. this person is the attesting witness to the signing of this document by the proper

corporate officer who is _____________________, the ______________________ of

(Name)

(Title)

the corporation.

c. this document was signed and delivered by the corporation as its voluntary act duly

authorized by a proper resolution of its Board of Directors:

d. this person knows the proper seal of the corporation which is affixed to this document;

and

e. this person signed this proof to attest to the truth of these facts.

Signed and sworn to before me on ____________________________, 20_______________.

Organization Corporation Hold Harmless Agreement Page 2