ODOT LPA RE 839 Rev. 01/2022	WA LPA

Work Agreement

by and between

*Name Of Seller(S)*

and

*Name Of Lpa*

*Name of Seller(s), the owner(s) of the property located at *Street Address or other description of location of subject property* situated in *County* County, Ohio [“Owner”] in consideration of there being no costs, assessments, or other expenses to Owner for the work hereinafter described, hereby authorizes the *Name of LPA*, and its duly authorized employees, agents, and contractors to enter upon said property for the purposes of performing the work described in Exhibit 1 attached hereto and by this reference incorporated herein.

This authority to enter granted to *Name of LPA* shall commence on Click or tap to enter a date. and will terminate on Click or tap to enter a date..

The work described in Exhibit 1 shall be performed in accordance with the plans and specifications prepared by *Name of LPA* for the construction and/or improvement of *LPA Route Designator*.

Owner hereby releases *Name of LPA* and its employees from any and all damages or claims for damages resulting by reason of the above described work and operations, excepting those arising from said plans and specifications. It is understood that any contractor engaged for the purposes described above is an Independent Contractor, and is solely responsible for any and all damages or claims for damages arising from any conduct not within the control of *Name of LPA*.

It is further understood that *Name of LPA* assumes no obligation for the maintenance of any area outside the limits of the permanent right of way.

Any and all of the terms, conditions and provisions of this Agreement shall be binding upon and shall inure to the benefit of Owner and *Name of LPA* and their respective heirs, executors, administrators, successors and assigns.

This Agreement may be executed in two or more counterparts, each of which will be deemed an original, but all of which together shall constitute but one and the same instrument.

No amendment or modification of this Agreement shall be valid or binding upon the parties unless it is made in writing, cites this Agreement, and is signed by Owner and *Name of LPA*.

In Witness Whereof, the parties hereto, namely the *Name of LPA* and *Name of Seller(s) have executed this Agreement on the date(s) indicated immediately below their respective signatures.

UNPROTECT FORM TO USE QUICK PART BUTTON FOR ACKNOWLEDGEMENT FORMS RE 830-C THROUGH RE 835-C FOR THE CORRECT FORM OF THE SIGNATURE BLOCK FOR EACH OWNER, AND INSERT AS NEEDED

DELETE THESE INSTRUCTIONS UPON FORMATTING EACH OWNER’S SIGNATURE BLOCK, AND DELETE OR ADD LINES AS NEEDED FOR PROPER APPEARANCE

Choose a building block.

Choose a building block.

*Name of LPA*
*Type Name of Signer*
*Type Office/Title of Signer*
Date: