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2. Harvester Contact Information
4. Name:*
5. Phone Number:*
7. Address:*
9. Email Address:
11. Note: In instances where more than one application is received for cutting hay in a particular roadside, preference will be given to the adjacent landowner.
13. Harvest Location
15. Intersection of (Twp Rd & Rge Rd):*
16. To (Twp Rd & Rge Rd):*
18. Side(s) or Road (N, S, E, W or both):*
19. Specific Area of Cut (5m, 10m, 15m, or all):*
21. By requesting the right to cut hay in a Red Deer County roadside, I understand that I must comply with the guidelines and procedures that the County has established:
    
    1. The hay being cut is for my own use.
    2. The annual deadline for haying requests is May 1.
    3. Cutting must be completed no later than August 1, and the bales are to be removed from the ditch no later than 72 hours after the bailing, or by August 15, whichever comes first.
    4. The noxious and prohibited noxious weed control is my responsibility for the duration of this request.
23. The harvester hereby:
    
    1. waives any and all claims, rights or causes of action of every nature and kind at law or equity or under any statute that it has or may have in the future against the County or its councillors, officers, employees and agents; and
    2. forever releases the County or its councillors, officers, employees and agents from any and all liability; related to injury, death, property damage, property loss or any other loss or expense that may be suffered by the Harvester or, to the extent legally possible, its employees, agents, next of kin or legal representatives, resulting directly or indirectly from, or in any way attributable to the work as provided by this agreement.
    3. shall be liable for, and does indemnify and save harmless the County, its councillors, officers, employees and agents from any claim, damages, liability, cost, fee, penalty, action, cause of action, demand, damage to property, injury to person or death (including, without limitation to, legal fees of the County on a solicitor and his own client full indemnity basis), whether in contract or in tort, suffered or incurred by the County, its councillors, officers, servants, employees or agents or by any other person, firm, partnership, corporation or entity resulting directly or indirectly from, attributable to, by reason of, arising out of, or in any way related to the transportation, operation, maintenance, repair, use, misuse, or non-use of the work done by the Harvester or any other person, whether or not the Harvester has permitted the person to perform the work or from any breach of this Agreement or any other negligent act or omission or willful misconduct of the Harvester or any of its directors, officers, servants, agents, contractors, or employees.
    4. acknowledges and agrees to provide evidence of general liability insurance coverage of not less than $2 million per incident. Such insurance coverage shall be maintained for the entire period that work is carried out in the County road right of way.
    
    If you have any questions or require more information, please contact Agriculture Services at 403.342.8654 or agriculture@rdcounty.ca.
25. Please submit your proof of liability insurance:*
27. PLEASE NOTE: This request is considered valid once confirmation from Red Deer County has been received, and is valid only until the hay has been removed from the ditch, or August 15 of the current year whichever happens first.
29. By checking the "I agree" box below, you agree and acknowledge that:
    1) Your application will not be signed in the sense of a traditional paper document.
    2) By signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.
    3) You may still be required to provide a traditional signature at a later date.*

    1. I agree
31. Electronic Signature*
32. Date:*
    Date:
34. The personal information on this form is collected under the authority of the Municipal Government Act and is protected under the provisions of the Freedom of Information and Protection of Privacy (FOIP) Act. If you have any questions about the collection, use and protection of this information, please contact Red Deer County at 403.350.2150.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field