We,
_______________________________________________________________,
agree to pick up litter two times a year for a minimum of two
years.
We request permission to pick up litter on PTH/PR
between _____________________ and _____________________
for a total of ________ kilometres.
Manitoba Transportation reserves the right to
refuse, cancel or revise this agreement if in its sole
judgment the nature of the group or its sign is political,
controversial or in questionable taste, or if the group is not
meeting the terms and conditions of this agreement. By signing
this agreement, the group acknowledges the hazardous nature of
the work and agrees to comply with the terms and conditions
herewith to the satisfaction of the Manitoba Transportation &
Government Services.
Except for the negligent acts of the Province,
its agents, and employees, the volunteers or their agents
shall assume all liability for, and save the province, its
agents and employees, harmless from, any and all claims for
damages, actions or causes of action arising out of the work
to be done herein.
Any and all volunteers of the group or other
persons while engaged in the performance of any work or
service performed under this agreement shall not be considered
employees of the province, and any and all claims that may or
might arise under the worker's compensation act of Manitoba on
behalf of said employees or other persons while so engaged,
and any and all claims made by any third party of the
group’s volunteers or other persons while so engaged on any
of the work or services to be rendered shall in no way be the
obligation or responsibility of the province.
(Please print)
Name of Group:
______________________________________________________________________
Name of Group Representative:
______________________________________________________________________
Signature:
______________________________________________________________________
Address:
______________________________________________________________________
Phone:
(home)__________________________
(work)_________________________________
Name to appear on sign:
____________________________________________________________________________
Special provisions:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
_____________________________________
Director of Regional
Operations |
Date: |
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