INDEMNIFICATION AGREEMENT
FOR VALUE RECEIVED, receipt of which is hereby
acknowledged, and for other good and valuable consideration, the
undersigned hereby agrees forever to indemnify and hold harmless
____________________ from and against any and all claims, suits,
damage or damages and/or loss or losses and/or action or actions
of any kind as the result of and arising out of
_________________________________________________________________
___________________________________________.
Dated:
______________________________ _____________________________
Witness
Form 615
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