What does the Indemnification Clause Acknowledgement cover?

It records the applicant’s agreement to indemnify the City and address defense, reimbursement, and other costs connected with project approvals and related proceedings.

Who completes this acknowledgement?

The applicant for a project submitted to Cupertino’s Planning Division provides the applicant and project details, then prints their name and title and signs.

Do I need a notary for the Indemnification Clause Acknowledgement?

No. The document has a signature and date line but no notary block, and it identifies no notarized attachment or sworn step.

Cupertino, CA · Santa Clara County

No notary required

Indemnification Clause Acknowledgement

This acknowledgement records an applicant’s agreement to indemnify and reimburse the City in connection with a project application submitted to Cupertino’s Planning Division.

What this form is

Applicants complete this acknowledgement as part of a project application to Cupertino’s Planning Division. It identifies the applicant and project address and sets out the applicant’s obligations concerning claims, defense costs, reimbursement, and other expenses related to project approvals and litigation. The document includes spaces for the date, printed name and title, and signature.

Who needs it

An applicant submitting a project application to Cupertino’s Planning Division needs to complete and sign this acknowledgement.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This acknowledgement is signed and dated without a notary; the document identifies no notarized attachment or sworn step.

How to submit this form

1
Download the Acknowledgement
Download the Indemnification Clause Acknowledgement PDF.
2
Complete the Applicant Details
Enter the application date, applicant name, and project address.
3
Sign and Date the Form
Print your name and title, then sign and date the acknowledgement.
4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What does the Indemnification Clause Acknowledgement cover?: It records the applicant’s agreement to indemnify the City and address defense, reimbursement, and other costs connected with project approvals and related proceedings.
Who completes this acknowledgement?: The applicant for a project submitted to Cupertino’s Planning Division provides the applicant and project details, then prints their name and title and signs.
Do I need a notary for the Indemnification Clause Acknowledgement?: No. The document has a signature and date line but no notary block, and it identifies no notarized attachment or sworn step.
How do I submit the acknowledgement?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Indemnification Clause Acknowledgement doesn’t need a notary — but if you have another Cupertino form that does, a commissioned online notary can help.