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Anoka County Highway Department <br />Ado t-a-Hi hwa Permit <br />p g Y Anoka County <br />(Check One) TRANSPORTATION DIVISION <br />Highway <br />X� Adopt -a -Highway. The group agrees to pick up litter at least two times a year for a minimum of two years. <br />U Pick -a -Highway. The group agrees to pick up litter one time only. <br />We request permission to pick up litter on <br />between <br />and <br />for a total of # miles. <br />Any and all volunteers of the group or other persons while engaged in the performance of any work or service performed under <br />this agreement shall not be considered employees of the County, and any and all claims that may or might arise under the <br />Worker's Compensation Act of Minnesota on behalf of said employees or other persons while so engaged, and any and all <br />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 <br />be rendered shall in no way be the obligation or responsibility of the County. <br />Except for the negligent acts of the County, its agents and employees, the volunteers or their agents shall assume all liability <br />for, and save the County, its agents and employees, harmless from, any and all claims for damages, actions or causes of <br />action arising out of the work to be done herein. <br />The Anoka County Highway reserves the right to refuse, cancel or revise this agreement if in its sole judgement the nature of <br />the group or its sign is political, controversial or in questionable taste, or if the group is not meeting the terms and conditions of <br />this <br />agreement. By signing this agreement, the group acknowledges the hazardous nature of the work and agrees to comply with <br />the terms and conditions herewith to the satisfaction of the Anoka County Highway Department. <br />Name of group <br />Responsible person <br />Signature <br />Address <br />Phone (home) <br />Name to appear on sign <br />Special provisions <br />County Engineer <br />(work) <br />Date <br />