Permission and Waiver of Liability

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PERMISSION and WAIVER OF LIABILITY HILCO Electric Cooperative, Inc. A Texas Non-Profit, Member-Owned Electric Cooperative "Owner : means _____________________________________________________, the undersigned property owner, tenant, officer of corporate property owner, official represenative or officer of civic or church group, or individual, who has authority to grant permission and release liability regarding the property, including Owner's family, employees, agents, invitees, tenants personal representatives, or assigns "Property" means: That property located in _______________ County, Texas ________________________________________________________________ ________________________________________________________________ (describe in acres, address, or location) "Works " means: -To install or maintain electric power to the property or adjoining property, the employees of HILCO E.C. must enter the property owned, or in the possession of, the Owner to do the following Work: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ "Owner" and HILCO Electric Cooperative, Inc. (HILCO E.C.) agree as follows regarding the property: Owner states that: (1) the property is owned, or in the possession and control of the Owner, who has the AUTHORITY to make this agreement: (2) Owner has the authority to grant HILCO E.C., and hereby grants HILCO E.C. PERMISSION to enter, or cross the property and perform the work, and (3) Owner WAIVES any right to any causes of action against HILCO EC for direct or consequential damages to Owner or Owners's property that might occur during the work. _______________________________________________ (Signature of property owner or legal representative) ________________________________________________ (HILCO E.C. representive)

_____________ 200__ (Date)