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2. I authorize the City of Everett, its officers, agents, employees and contractors (collectively, the "City") to enter the property listed below ( the "Property") to remove graffiti. I authorize the City to use the Property's water supply for graffiti removal. The City will only remove graffiti visible to the public. If paint is used to cover graffiti, it may not match the existing paint precisely. The City may not be able to remove all the graffiti. I waive and release the City from all claims and liabilities resulting from the graffiti removal, including, but not limited to, all claims related to property damage or injury to persons.
4. I will also indemnify, defend and hold the City harmless from and against all such claims and liabilities to the extent caused by my negligence. I will cooperate with the City to identify and prosecute the person(s) responsible for the graffiti. If the person(s) responsible for the graffiti are prosecuted, I will seek restitution from them. If the Court orders restitution to me, but not to the City, I will reimburse the City for all costs of the graffiti removal up to the amount of the restitution.
6. This Consent Form expires one hundred eighty (180) days from the latest signature date below. I may terminate this Consent Form at an earlier time by providing written notice to the City. I certify that I read and understand these conditions. I also certify that I did not cause or allow the placement of the graffiti on the Property. If the Property is a single family residential rental property, then both the property owner and the lawful tenant must agree to these conditions.
8. Property Address
10. Location of graffiti on the Property
12. Approximate date graffiti was placed on the Property.
14. First Name
15. Last Name
17. First Name
18. Last Name
20. Phone Number
22. Date
    Date
24. I am the

    1. Property owner
    2. Property manager

    1. Tenant of Single Family Rental
26. Acknowledgement*

    1. I agree

    In pressing the submit button, you agree that the information provided is accurate. Submission is in lieu of a signature.
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field