South Chicago Heights, IL · Cook County
Contractor’s Hold Harmless and Indemnification Agreement Waiver
This sworn agreement is for contractors doing business in the Village who state they have no employees and agree to hold the Village harmless for claims tied to construction work.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
This agreement is intended for a contractor doing business in the Village who states that they have no employees and are not required by law to obtain workers’ compensation insurance. The contractor also agrees to hold the Village, its officers, and its employees harmless from specified claims connected with Village-authorized or permitted construction. Use the form when the Village requires this agreement for a contractor’s work.
Who needs it
A contractor doing business in the Village may need this agreement when stating they have no employees and accepting responsibility for specified construction-related claims.
Why it needs a notary
The form carries a “Subscribed and Sworn to before me” jurat, so the contractor’s representative signs and swears to the statement before the notary.
How to get this notarized
- 1
Download The Form
Download the Contractor’s Hold Harmless and Indemnification Agreement Waiver from the Village.
- 2
Complete The Form
Enter the contractor representative’s name, company, signature, date, and license number as applicable.
- 3
Book An Online Notary
Schedule a session with a commissioned online notary and have identification ready.
- 4
Sign On Video
Sign and swear to the statement during the online notary session.
- 5
Submit To The Village
Submit the completed, notarized form to the Village of South Chicago Heights.
Preview the form
The blank PDF straight from South Chicago Heights. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete and notarize this contractor waiver?
- Fill out the contractor and company information, then book a commissioned online notary. Sign and swear to the statement during the video session, and submit the completed form to the Village.
- Do I need to sign this form in front of a notary?
- Yes. The form includes a “Subscribed and Sworn to before me” jurat. The contractor’s representative should sign and swear to the statement before the notary.
- Can I use remote online notarization for this form?
- Illinois authorizes electronic and remote notarization for its own notaries under the Illinois Notary Public Act (5 ILCS 312) and recognizes notarial acts performed outside Illinois by an officer authorized where the act occurs. Confirm with the city or village if unsure.
- What does the contractor agree to in this waiver?
- The contractor states they have no employees and are not required to obtain workers’ compensation insurance, and agrees to hold the Village and its officers and employees harmless from specified claims related to construction.
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