1333 Washington StWASHINGTON COUNTY NEBRASKA
Filed for record on November 18, 2021 at 10:18 AM
Instrument No. 2021-05350
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%ar&o1ynPMVo'dola, Register of s
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Prepared by and after Recording Return to:
Brenda Wheeler, City Clerk, City of Blair, 218 S 16°i Street. Blair, NE 68008 (402) 426-6694
DATE OF INSTRUMENT: /)90 j?2/5
The undersigned, hereinafter referred to as "Owner", whether one or more of the following
properties, is required by Section 9-201.01 of the Municipal Code of the City of Blair to install a
key lockbox for access to the premises by the Blair Volunteer Fire - Department.
Owner warrants and represents that he/she is owner of the following described real estate:
LEGAL: Lots 9-15, Block 49, City of Blair, Washington County, Nebraska
ADDRESS: 1333 Washington, St., Blair, NE 68008
PIN: 890044534
Owner hereby specifically acknowledges the following:
1. Owner acknowledges that the Blair Volunteer Fire Department encourages all owners of
buildings not regularly occupied for twenty-four (24) hours every day for seven (7) days
of the week to install a key lock box to provide safe and immediate access to the building
in case of fire or emergency.
2. Owner acknowledges that the Blair Volunteer Fire Department enforces rules and
regulations for the authorized use of the key lock box system by fire department
personnel and volunteers.
3. Owner acknowledges the following safety benefits derived from installing and using a
key lock box:
a. Immediate building entry by firefighters without waiting for building keys.
b. Eliminate needless forced -entry damage.
c. If a fire alarm is installed, maintain building security after an alarm
investigation by allowing the fire department to relock the undamaged building.
d. If a sprinkler system is installed, immediate building entry will help protect inventory,
equipment and supplies from unnecessary water damage caused by delayed sprinkler
shut-off.
4. Owner acknowledges that without a key lock box the Blair Volunteer Fire Department
during a fire call will gain access into the building through whatever alternative means
are available to them.
5. Owner acknowledges and agrees that this waiver releases, waives and discharges the City of Blair
and the Blair Volunteer Fire Department, their employees, officers, directors, agents,
representatives, and management (hereby referred to as "Releasees") for any and all loss or
damage to the property caused by a forced entry into the property that occurs within the normal
scope of the Blair Fire Department operating procedure.
6. Owner hereby agrees to indemnify and hold harmless the Releasees from any loss, liability,
damage, or cost they may incur arising out of the entry.
7. Owner hereby assumes frill responsibility for any property damage arising out of the entry
and hereby aclalowledges that the activities involved are of a hazardous nature and
contain ii-dierent risks of serious, property damage.
8. Owner also expressly aclazowledges that this waiver extends to all acts of entry by rescue
operations and is intended to be as broad and inclusive as is permitted by the laws of the
State and that if any portion thereof is held
CERTIFICATION BY APPLICANT
I, �t �.certify that I Have read
and understand the acknowledgements, and requirements listed above. I hereby request the
City of Blair to waive the Key Lock Box Safety Requirement for my business located at the
above- d e s c r i b e d real estate. I further understand that should the Blair Volunteer Fire
Department be required to gain access into the building through alternative means I agree to
release, indemnify, and save harmless the Blair Volunteer Fire Department, and the City of
Blair, from any and all causes of action, damages, claims, suits or any other liability of any
nature or kind arising out of or resulting from such access to the structure by the Blair
Volunteer Fire Department.
Dated: I&R&I I ee- ,20
Owner(s) Gretna Properties, LLC
STATE OF NEBRASKA)
)ss
WASHINGTON COUNTY)
The foregoing instrument was acknowledged before me on nb IS20ZL
_ VV.-
MARY• sale orNenrasa�
LINDA K. DENNIS
�1Y Comm. Fes, July 24,2M
Distribution List:
L Fire Chief of the Blair Volunteer Fire Department
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