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Employer Indemnity Agreement
The undersigned, in consideration of being by [Company] agrees to fully indemnify and hold harmless the Company from any claim by any third party alledging wrongdoing or neglect on my part, and for any expense or loss incurred by the Company as a result of any violation of state or Federal law, agency rule or regulation that was within the scope of my employment to obey or cause the Company to obey. Any claims for which the Company is adequately insured and/or any liability to which the Company or any other employee shares responsibility are exempt from this indemnity. In the event of any asserted claim against the Company, I will defend at my own expense, save harmless, indemnify and reimburse the Company for any loss or liability that may arise from such asserted claim.
Signed and dated this [Date].
Position in Company [Enumerate].
*** If Required By State Law ***
This Section for Notary:
STATE OF -------)
) ss: [Date]
COUNTY OF ------)
On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
[Name of Notary Public]
My commission expires: [date]