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,;,:4 �l. SRN r <br />OFFICE OF <br />�U ASSESSOR -COUNTY CLERK- <br />_ .. - RECORDER & ELECTIONS <br />COUNTY OF SAN MATEO <br />p 011 <br />Payment for the use of Facility shall be as indicated below: <br />Facility agrees to waive payment. <br />❑Full payment required. $ <br />(Facility must provide W-9) <br />❑Full payment required. $ <br />(Facility must provide W-9) <br />❑Partial payment. $ <br />(Facility must provide W-9) <br />MARK CHURCH <br />CHIEF ELECTIONS OFFICER & <br />ASSESSOR -COUNTY CLERK -RECORDER <br />per day that the Facility is used by the Division. <br />total for all days that the Facility is used by the Division. <br />per day for the following days: <br />If payment is not waived, the Facility shall provide an invoice to the Division no later than June 28tH <br />2022, or five business days following the execution of this Agreement, whichever is later. <br />No amendment to this Agreement will be effective unless it is agreed to by Authorized Staff. <br />The Facility agrees to indemnify, defend, and hold harmless the County of San Mateo, and its agents, <br />representatives, servants, contractors, employees, volunteers, successors, and assigns from and <br />against any and all liability, claims, damages, and causes of action of any kind whatsoever, caused by <br />the Facility and/or its agents, representatives, servants, contractors, employees, successors, and as- <br />signs involving the Facility or Vote Center. <br />The County of San Mateo agrees to indemnify, defend and hold harmless <br />City of Redwood City and its agents, <br />representatives, servants, contractors, employees, volunteers, successors, and assigns from and <br />against any and all liability, claims, damages, and causes of action of any kind whatsoever, caused or <br />alleged to be caused by the County of San Mateo, the Vote Center equipment and related materials <br />or equipment brought into the Facility, and/or the County's agents, representatives, servants, contrac- <br />tors, employees, volunteers, successors, and assigns involving the use of the Facility for conducting <br />voting as a Vote Center. <br />I, THE UNDERSIGNED, ACKNOWLEDGE THAT I HAVE AUTHORITY TO ACT ON BEHALF OF <br />THE FACILITY. I HAVE READ AND UNDERSTAND THE ABOVE TERMS OF THIS AGREEMENT <br />AND, BY SIGNING BELOW, AGREE THAT THE FACILITY WILL COMPLY WITH SUCH TERMS. <br />Signature <br />Melissa Stevenson Diaz <br />Print Name <br />2/10/22 <br />Date <br />40 Tower Road, San Mateo, CA 94402 <br />P 650.312.5222 F 650.312.5348 email registrar@smcacre.org web www.smcacre.org <br />ATTY/AGR.2022.027/San Mateo County Office of Elections (Page 2 of 2) <br />