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~I _^ ~ . • <br />aya Dl~t`1 j~ ~' <br />San Miguel Basin Weed Program <br />Box 130 <br />Norwood, CO 81423 <br />Phone 970 327-0399 Fax 970 327-4090 <br />Property Owners Consent Form for the Application of <br />Herbicide to Control an Infestation of Noxious Weeds <br />The undersigned Property Owner, hereinafter referred to as "Participant", understands and <br />acknowledges that the contemplated application of herbicide to control an infestation of noxious <br />weeds is a privilege and not a right. However, as consideration for the application of herbicide <br />Participant acknowledges and wishes to freely enter into the following agreement, waiver and <br />release. <br />Participant acknowledges and represents that they have been advised that Property they own or <br />lease within San Miguel County appears to contain an infestation of a Noxious Weed, <br />specifically , as designated by the State of Colorado and <br />San Miguel County, State of Colorado. <br />Participant hereby acknowledges, agrees, gives permission and requests that San Miguel County, <br />the San Miguel Basin Weed Advisory Board and the Board's authorized representatives, <br />including any licensed applicator employed by the San Miguel Basin Weed Advisory Board, <br />hereinafter ("the County"), enter this Property for the purpose of controlling and monitoring of <br />the infestation. Participant expressly agrees and acknowledges to compensate the County for <br />said controlling and monitoring of the infestation, including the application of herbicide when <br />appropriate in the opinion of [he authorized representative of the County, at the rate of <br />$_65.00 per hour spent in performing the controlling of noxious weeds contemplated in <br />this Agreement plus the costs of all materials and herbicide. <br />Participant hereby acknowledges that they have been informed that control efforts will involve <br />the use and application of herbicide and/or the release of insects. <br />Participant acknowledges that they have been informed that before any treatment will be <br />undertaken that they will be informed of the proposed treatment plan and will have an <br />opportunity to see the treatment area and to be involved in the treatment if they so wish. <br />Participant hereby agrees to protect, defend, indemnify, and hold harmless the County, and <br />officers, agents, employees and volunteer workers of the County, from and against all liabilities, <br />obligations, claims, damages, penalties, causes of action, judgments, costs and expenses <br />(including without limitation, actual attorneys fees and expenses) imposed on or incurred by or <br />asserted against the County for any reason as a result of the application of herbicide to control an <br />infestation of noxious weeds on Participant's property, whether such liabilities, obligations, <br />claims, damages, penalties, causes of action, judgments, costs and expenses (including without <br />limitation, actual attomeys fees and expenses) arise from negligence of the Participant or the <br />County, its officers, agents, employees and volunteer workers or any other person. <br />C: \w i ndows\TEMP\pri vale. agree m ent. doc <br />Page 1 oft <br />