The Contractor, for and in consideration of a building permit issued by the City of Crestview, Florida, agrees to indemnify and hold harmless said City of Crestview, Florida, its officers, and Agents, from all claims, damages or expenses that the City of Crestview may be liable for which arise from the construction or doing of any work by the contractor within, the City of Crestview, Florida.
The Contractor agrees to deliver to the licensing division of the City of Crestview, a Certificate of Liability Insurance evidencing coverage and naming the City of Crestview as the certificate holder, and which further requires ten (10) days notice to the City of Crestview of any cancellation or reduction of coverage. Said certificate evidencing insurance coverage, shall be presented prior to the start of any work or construction on the project for which the building permit is to be issued.
This is to certify that the below listed person(s) whose signature(s) appear below is/are my employee(s), partner(s), and/or officers(s) and are authorized to purchase permits and/or call for inspections. The people listed on this form, other than the license holder, will be the ONLY people allowed to purchase permits and/or call for inspections.
I further submit that I am knowledgeable of Florida Statutes, Chapter 489. I understand that I have full responsibility for compliance with all statutes, codes, and laws inherent in the privilege, granted by issuance of such permits.
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If at any time the person(s) you have authorized is/are no longer your employee(s), partner(s) and/or officer(s), you must notify our department in writing of the changes.
198 North Wilson Street
Crestview, FL 32536
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