HomeMy WebLinkAboutBenefits Trust General Contract of IndemnityMeridian City Council Meeting Agenda December 3, 2019 – Page 240 of 296
WE HAVE READ THIS CONTRACT OF INDEMNITY CAREFULLY. THERE ARE NO SEPARATE AGREEMENTS OR
UNDERSTANDINGS WHICH IN ANY WAY LESSEN OUR OBLIGATIONS AS ABOVE SET FORTH. THIS AGREEMENT IS IN
ADDITION TO AND NOT IN LIEU OF ANY OTHER AGREEMENTS AND OBLIGATIONS UNDERTAKEN IN FAVOR OF COMPANY,
WHETHER NOW EXISTING OR ENTERED INTO HEREAFTER. IN TESTIMONY HEREOF, WE THE INDEMNITORS HAVE SET OUR
HANDS AND FIXED OUR SEALS AS SET FORTH BELOW.
If Indemnitor is an entity, sign below:
Instructions: Two authorized officials should sign on behalf of each entity (except as otherwise indicated below) and all signatures must be
notarized and dated. The date of this Agreement shall be the earliest date any Indemnitor executes this Agreement. If the entity is: 1) a
corporation, the secretary (if one exists) and another authorized officer should sign on behalf of the corporation; 2) a limited liability company,
the manager(s) (if any) or member(s) should sign on behalf of the LLC; 3) a partnership, the partner(s) should sign on behalf of the partnership;
4) a trust, the trustee(s) should sign on behalf of the trust; or 5) any other type of entity, including governmental entities, any two authorized
officials. If the Indemnitor is a sole officer corporation, single member LLC, or any other entity where only one individual is authorized to sign
on behalf of the entity, only one signature is required. Please provide the entity's federal tax identification number on the line provided.
Notwithstanding any of the foregoing, failure to complete this Agreement in accordance with these instructions shall in no event affect the
validity of this Agreement.
Each of the undersigned hereby affirms to Company as follows: I am a duly authorized official of the entity on whose behalf I am executing
this Agreement. In such capacity I am familiar with all of the documents which set forth and establish the rights which govern the affairs,
power and authority of such entity including, to the extent applicable, the certificate or articles of incorporation, bylaws, corporate resolutions,
and/or partnership, operating or limited liability agreements of such entity. Having reviewed all such applicable documents and instruments
and such other facts as deemed appropriate, I hereby affirm that (a) such entity has the power and authority to enter into, execute, deliver and
perform this Agreement and to carry out the obligations stated herein, (b) the individuals executing this Agreement on behalf of such entity are
duly authorized to do so, and that (x) the execution, delivery and performance of this Agreement by Indemnitors; (y) the compliance with the
terms and provisions hereof; and (z) the carrying out of the obligations contemplated herein, do not, and will not, conflict with and will not
result in a breach or violation of any terms, conditions or provisions of aforementioned applicable documents and instruments, or any law,
governmental rule or regulation, or any applicable order, writ, injunction, judgment or decree of any court or governmental authority against
any Indemnitor(s), or any other agreement binding upon any Indemnitor(s), or constitute a default thereunder.
City of Meridian 82-6000225
Indemnitor - Corporatio acted Lia Company, Partnership, (Federa ai
Trust, or O rcle one
B Seal B
(Signature of Authorized Official)
Tammy deWeerd Mayor
(Print or Type Name and Title) (Date)
33 East Broadway Avenue Meridian, ID 83642
(Address)
)rl1J w
(Print or Type Name and
Idaho
Lv
(Date)
(State of Incorporation / Formation)
IN
ACKNOWLEDGEMENT
State of T- (N (I I ) U County of f-�
O this ! 1-11day of De, C eXY-1Y V -V ,201 , before me personally appeared � (UT c1YY� � � known or proven to me to be the
of the entity executing the foregoing instrument ("Entity), and xt known or
proven4 me to be the of the Entity, and they acknowledged said instrument to be the ee and voluntary act and
deed of Entity for the uses and purposes therein mentioned and they acknowledged that they executed said instrument by authority of Entity. IN
WITNESS WHEREOF, I have hereunto set my hand and affixed my OFFICIAL SEAL the day and year first above written.
&
Notary Public (Signature
CHARLENE WAY
COMMISSION #67390
NOTARY PUBLIC
STATE OF IDAHO
MY COMMISSION EXPIRES 3/28/22
01-y1y pyla L66( -u a
Notary Public (Print 6 Type Name)
Notary Public residing at: "e 1,i& &)1
Commission expires:3-�� -2O 22
S-5357 (12-16) Page 2 of 3
City of Meridian - Indemnity Agreement
City of Meridian Employees Benefits Plan Trust
Indemnitor - Corporation, Limited Liability Company, Partnership,
Trust r Other (circle one)
B jjK"D(Seal)
(Signature IAuthorized Official)
Christena Barney Senior HR Generalist
(Print or Type Name and Title) (Date)
33 East Broadway Avenue, Meridian ID 83642
(Address)
ACKNOWLEDGEMENT
State of :re,," n County of "n ,
(Federal Ta ID) y�
-Y / ' Seal
(Signature bfAULhoriz d Official)
William Lloyd Mossman Nary City Councilor
(Print or Type Name and Title) (Date)
Idaho
(State of Incorporation / Formation)
On this,14�ay of/yyJ?_ V+2�eQtiYiiigbefore me personally appeared li'S k vtu ✓ n.�.., , known or proven to me to be the
-N�� �G' t5 t.L& q29_ of he entity executing the foregoing instrument ("Entity"), and w i 1I ('A,in,, 1_M N a T L I , known or
proven to me to be the -(�y�g�f S 'rrusAP C of the Entity, and they acknowledged said instrument to be the free and vofuntary act and
deed of Entity for the uses and purposes therein mentioned and they acknowledged that they executed said instrument by authority of Entity. IN
WITNESS WHEREOF, I have hereunto set my hand and affixed my OFFICIAL SEANL the day ea
year first/a cove �written.
ra••00 0 ��®�•. Notary Public (S gnature)
Q
0A Notary � Notary Public (Print or Type Name)
o"COMMISSION,; 0 ; Notary Public residing at:
o #131366 �� •
�%�` _4tG O Commission expires: ?j a _ a ZL
'/► �tll�
Apo OD0pe
S-5357 (12-16) Page 3 of 3
City of Meridian - Indemnity Agreement