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IYYYYS Y1Y8 YIIdJ Address: Attachment 1 Anti - Graffiti Program Public M ovks Ageuec Maintenance Division "a South Diio y Avenue, Smug Ana., Califon ra 93702 Tek- plwue: (714) 647 -3339 Fax: (714) 647 -3345 CONSENT TO ENTER & RELEASE OF LIABILITY TO THE CTIN OF $ANTA ANA AND THE GRAFFITI REMOa'AL C'03IP.ANY: B isnstsR Name: Effective dare of audrarizatian. Frain 11M , � ,'"� t� 16 1 Santa Ana. CA Authorization is effective from the dare Cantsenr to Eager is signed until permission is denied by written notification. ❑ The City of Santa Ana may use any of its five .specific colors of paint to the removal of the g xffiti- The undersigned owner of the prgrerty., or agent representing the property oumer at the address noted above., hereby consents to entry upon said prger2y by personnel and equipnent of the City of Sama Ana or its Contractor a. is necessuy to remove, reduce obliterate the wrinug of graffiti on the Please check: ❑ Building, ❑ Fence ❑ Wall ❑ Other improvement by using vapor steal, water blasting, paimilag, or list of soh "eats. I understand that the clearing tiny be in blocks or strips where the levering appears mid that the cleaned or processed area away not crutch precisely the original surface but every effort is-All be made to snatch colors to the remainder of trite above to tric,verrients, that the clearing will not include the entire surface, but only block.. patches or strips thereof.. and the C'bntractor and the City issurue no tesponsibility if colors do not preasely uriach, and that some residue of the existing graffiti may remain. I request and authorize the City of Santa Ana or its Contractor to enter and use said equipment and materials with my All] imovs ledge of the above information - I hereby release the City of Santa Ana and its Contractor, its officers, agents mid employees, of and from any -all claloas, derunds, causes of action or obligations whatsoever arising out of or relating, to envy ors toy property, and incidental damage to doings and plants, the cleansing operations hereinabove de,scr4bed. and final appearance of said Improvements, Print Naine, Signature: Telephone: Title. ❑ Owrrer ❑ Agent ❑ Manager Date Signed: ROw if signed form to: Public \1 "orks Agency— \laintenance Division Attn: Graffiti Abatement C: rem Supervisor 229 South Daisy, Building A Santa Atka, C:A P2792 City of Santa Ana GRSC Services RFP Page 57