Waiver Of Liability And Release

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C
S
A
ONSTRUCTION
ITE
CCESS
W
L
R
AIVER OF
IABILITY AND
ELEASE
Visitor Name (print): _______________________________________________________
Construction Program: I-95 New Haven Harbor
Crossing Corridor Improvement Program
Child Name (if applicable and print) if under age 18: ______________________________
Construction sites to visit: Projects #92-531, 532,622,
Full Mailing Address: _______________________________________________________
627, the reconstruction of I-91, 95, State Route 34 and
Email Address: ____________________________________________________________
local roads and access points.
Phone: __________________________________________________________________
Program Owner: Connecticut DOT
Emergency Contact Person: __________________________________________________
Emergency Contact Phone: __________________________________________________
Relationship to Visitor(s): ___________________________________________________
The Undersigned has requested to be permitted access to the Construction Sites for the above-named Construction Program. The
Undersigned agrees and represents that he/she is aware that there are ongoing construction activities at the Construction Sites. The
Undersigned further agrees and represents that construction sites are a dangerous environment, including the above-referenced
Construction Site, despite the precautions for safety taken by the Connecticut Department of Transportation (CTDOT), Walsh/PCL Joint
Venture II (WPJV), O&G Industries, Inc., Tutor Perini Corporation, a Joint Venture (OGTP), its subcontractors, or others performing work at
the construction site. In consideration of being granted the right to access the Construction Sites, the Undersigned has agreed to execute this
Waiver of Liability and Release and be bound by the terms hereof.
WHEREFORE, the Undersigned, for himself and for his personal representatives, heirs, next of kin, and assigns, acknowledges and agrees:
1.
The Undersigned acknowledges that he/she fully understands that construction and other activities at the Construction Sites
are dangerous and involve risks of serious injury, death, and/or property damage.
2.
To the fullest extent permitted by law, the Undersigned (and on behalf of the Undersigned’s personal representatives, heirs, next
of kin, and assigns) RELEASES, WAIVES AND DISCHARGES, AND COVENANTS NOT TO SUE, the Connecticut Department of
Transportation (CTDOT), Walsh/PCL Joint Venture II (WPJV), O&G Industries, Inc., Tutor Perini Corporation, a Joint Venture
(OGTP), Engineer, any contractor or subcontractor or person engaged by any of them to perform any work or services at the
Construction Sites, and their officers, directors, stockholders, members, employees, representatives, agents, employees, parents,
subsidiaries, sureties, insurance companies, affiliates, partners, joint ventures, attorneys, predecessors, successors, and assigns
(collectively, the “Releasees”) from any and all damages, losses, penalties, liabilities, costs, attorney’s fees and expenses of any
nature, and any demands, claims, suits, and causes of action therefor, arising out of or resulting from the Undersigned’s presence
at the Construction Sites.
3.
The Undersigned ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF, INJURY TO HIS/HER PERSON OR HIS DEATH or damage to
his/her property, whether caused by the negligence of the Releasees or otherwise, occurring during or as a result of the
Undersigned’s presence at the Construction Sites.
4.
To the fullest extent permitted by law, the Undersigned shall indemnify, defend and hold harmless the Connecticut Department of
Transportation (CTDOT), Walsh/PCL Joint Venture II (WPJV), O&G Industries, Inc., Tutor Perini Corporation, a Joint Venture (OGTP),
Engineer and all of their officers, directors, stockholders, members, affiliates, parents, subsidiaries, employees, agents, sureties,
insurance companies, predecessors, successors and assigns (collectively, the “Indemnitiees”), from and against any and all demands,
claims, suits, causes of action, damages, losses, penalties, liabilities, costs, attorney’s fees and expenses of any nature, arising out of
or resulting from the Undersigned’s presence at the Construction Sites. This indemnity obligations shall not be construed to negate,
or abridge, or otherwise reduce any other right or obligation of indemnity which would otherwise exist under law except to the
extent that it is caused by the sole negligence of any party indemnified hereunder in which case this obligation shall not apply
relative to such indemnified party.
5.
The Undersigned acknowledges that he/she has sole responsibility to evaluate carefully the risks inherent in accessing the
Construction Sites and that he/she has fully considered those risks, including, without limitation, dangers posed by willful or
negligent conduct of himself/herself and/or by others.
6.
The Undersigned acknowledges and voluntarily assumes full responsibility for, and full risk of, property damage or loss, or bodily,
mental, or personal injury, including death, relating to his/her presence at the Construction Sites.
7. The Undersigned agrees that if any portion of this document is held invalid, the remaining provisions shall be binding and continue
in full force and effect.
I have read this Waiver of Liability and Release carefully, understand its significance, and voluntarily agree to all of its terms.
Signed Visitor Name: _________________
Date:_____________________________
**I am the parent/legal guardian of the child named on this Waiver. I have carefully read and understand this Wavier of Liability and
Release’s significance, and voluntarily agree to all its terms as parent/legal guardian of this child.
Signed Parent/Legal Guardian Name: _________________
Date:_____________________________

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