DOCUMENT INFORMATION AND INSTRUCTIONS
Form Ref.:OGC-SC662
Description:Use Agreement – 4-H -- One-Time
This form is used by the Minnesota Extension Service on behalf of 4-H Youth Programs when the University uses non-University premisesfor a single use.
Here are the instructions. Enter the indicated information in the word-fillable fields (when your cursor is in the word-fillable field, these instructions can also be found on the status bar located at the bottom of your computer screen). PLEASE NOTE: If you do not have the information at hand to fill in the word-fillable field, you will need to insert an underline (____) so that you will have space to enter the information after you print out the agreement.
First Paragraph
Enter the date when the agreement begins (ex. April 15, 2009)
Enter the name of the company who will be the Landlord
Enter the legal status of the company (ex.: Minnesota corporation, Minnesota limited liability partnership or Minnesota limited liability company)
Enter the name of the County (ex. Ramsey, Hennepin, Washington)
Enter the name of the University employee to whom notices should be sent
Enter the address (include building address, street address, city, state and zip code)
Enter the telephone number (ex. (612) 626-6666)
Enter the Landlord's address (include street address, city, state and zip code)
Enter the Landlord’s phone number (ex. (952) 998-0202)
Paragraph 1. The Premises
Enter the county where the premises are located (ex. Carver)
Enter a description of the premises (include rooms, area, building name, street address, city and zip), including the number of parking spaces needed, if any
Paragraph 2. Use
Enter the start hour when University will use the Premises (ex. 7:30 a.m.)
Enter the end hour when University will use the Premises (ex. 6:00 p.m.)
Enter the date(s), including the year, when University will use the Premises (ex. May 1-15, 2009)
Enter description of the purpose for which University will use the Premises (ex. , presenting conference on "What 4-H Means", etc.)
Paragraph 4. Fee
Write out the dollar amount of the fee University will pay (ex. five hundred seventy-five)
Enter the numerical rendering of dollar amount of fee University will pay (ex. 575.00)
Enter the date the University will pay the fee to the Landlord (ex. April 25, 2009)
Signature Block
Enter the name of the Landlord
Enter the name of the University employee delegated the authority to sign the agreement on behalf of the Regents of the University of Minnesota (See to find person with signature authority)
Enter the name of the Landlord employee who will be signing the agreement
Enter the title of the University employee delegated the authority to sign the agreement
Enter the title of the Landlord employee who will be signing the agreement
FORM: OGC-SC662
Form Date: 10.13.06
Revision Date: 12.07.06
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License Number
4-H/Extension
USE AGREEMENT – 4-H
THIS USE AGREEMENT (the “Agreement”) is entered into on, between, a , the (“Landlord”) and the Regents of the University of Minnesota, a Minnesota constitutional corporation (“University”). This Agreement is entered into by the University through its Extension Service, 4-H Youth Programs, County/Regional Office, Attn: , , . Landlord’s address and telephone number is and .
1.The Premises. Landlord grants to University the right to use the premises, including common areas, located in County, Minnesota described as follows:
Landlord is not aware of any condition in, on, or about the Premises which constitutes a hazard to the safety of any occupant or which violates any governmental law or ordinance intended to protect human safety.
2.Use. University will use and occupy the Premises, just as they are, during the hours of to on the following date(s): for the following purpose(s): .
3.Services. Landlord will provide all services reasonably required for University’s use of the Premises, including heat or air-conditioning, electricity, water/sewer, garbage removal, and janitorial services.
4.Fee. University will pay the sum of and NO/100 dollars ($) for its use of the Premises. University will pay this fee to Landlord atthe address listed above on or before .
5.Insurance and Indemnification.
5.1University shall obtain and keep in force comprehensive general liability insurance, including coverage for bodily or personal injury, and property damage with limits of not less than $1,000,000 each claim and $3,000,000 each occurrence. University represents that it has workers’ compensation insurance to the extent required by law and agrees to furnish proof of such insurance upon request.
5.2University agrees to indemnify, release and hold harmless Landlord from liability for claims for bodily and personal injury and property damage occurring on the Premises during University’s use, except to the extent such injury or damage is caused by the willful or negligent acts or omissions of the Landlord, its agents, employees or representatives. University will not be responsible for claims for bodily injury or property damage caused by any 4-H Club, federation or similar organization and/or its individual member, or events or activities whose main function is not educational.
5.3Landlord agrees to indemnify, release and hold harmless University liability for claims for bodily and personal injury or property damage occurring on or about the Premises or building of which Premises is a part of, except to the extent such injury or damage is caused by the willful or negligent acts or omissions of the University, its agents, employees, representatives and/or volunteers who are under the direction and the control of the University.
6.Notices. All notices and other communications will be in writing and will be delivered personally, or by facsimile or electronic mail (provided such delivery is confirmed), or by overnight courier service or by first-class United States mail to the other party at the address provided in this Agreement.
7.Amendments. This Agreement may only be amended in writing by mutual agreement of Landlord and University.
8.Use of University Name or Logo. Landlord will not to use the name, logo, or any other marks of the University (including, but not limited to, colors and music) in any manner whatsoever, without the express written permission of the University in each instance.
9.Governing Law; Forum. The laws of the state of Minnesota shall govern the validity, construction and enforceability of this Agreement. All suits, actions, claims and causes of action relating to the construction, validity, performance and enforcement of this Agreement shall be brought in the state courts of Minnesota.
IN WITNESS WHEREOF, University and Landlord have executed this Agreement on the day and year first above written.
Regents of the University of Minnesota,
By: By:
Name: Name:
Title: Title:
Date: Date:
FORM: OGC-SC662
Form Date: 10.13.06
Revision Date: 12.07.06
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