Description of Premises:
Street and Number
Owner
Tenant
Adjoining Properties
Times and Days During Which Trespass is Prohibited:
We, the undersigned, do hereby nominate, designate and appoint the Town of Scotland Neck Police Department as agents of the undersigned for the purpose of carrying out this agreement, and as such agents of any corporation employing such undersigned, and we do hereby authorize and direct the said officers of the Town of Scotland Neck Police Department to inform and advise any and all persons upon the premises designated above during the times and days set forth in above and that such persons are forbidden to enter upon or remain on said premises, and that such persons are trespassers. The undersigned further certifies that, should any unauthorized person or persons so trespass upon said premises and refuse to leave, resulting in criminal prosecution, the undersigned will appear in court to testify concerning authentication of this agency designation and of this authority to order persons to leave or forbid entry upon said premises.
This agreement shall take effect on the ______ day of ________, 20_____, and shall remain in force for a period of 24 months from said date; PROVIDED, however, that either of the undersigned or the Town of Scotland Neck Police Department, may terminate and revoke this agency at any time sooner than the period herein specified, without assignment of reason, and without any particular notice period being required of such party wishing to revoke, so long as notice of such revocation is delivered in writing to the other party.
The undersigned further certifies that the undersigned will, at the undersigned’s expense, erect or cause to be erected, prior to the effective date of this agreement, not less than two signs of a minimum size of two feet by two feet, on visible portion of the premises referred to above, stating in specific detail the days and times during which trespassing is prohibited upon these premises.
The undersigned further certifies that if this agreement is being executed by the undersigned as an employee or an agent for another person, or for a corporation or partnership, that, in such event, the undersigned has prior to the execution of the agreement, obtained necessary and appropriate authority for the execution of this agreement:
Executed this day of , 20 .
TENANT: | OWNER: |
TITLE: | TITLE: |
CORPORATION/ORGANIZATION | CORPORATION/ORGANIZATION |
Subscribed before me this day of , 20 . | Subscribed before me this day of , 20 . |
(seal) | (seal) |
Notary Public | Notary Public |
My Commission Expires: | My Commission Expires: |
Appointment of Agency accepted on behalf of the Town of Scotland Neck Police Department by
Chief of Police
Subscribed before me this day of , 20 .
(seal)
Notary Public
My Commission Expires:
(Ord. passed 8-22-2000)