SOMA West CBD Graffiti Removal Consent Form
Please use this form to grant us permission to remediate graffiti. You will receive an email copy after you have completed this form.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Name of Legal Entity (If applicable)
SOMA West property address *
Phone number *
I acknowledge that I am the owner or owners, or authorized representative of the property listed above and which is located within the boundaries of the SOMA West Community Benefit District of San Francisco. I hereby request and authorize the SOMA West Community Benefit District, or its designee, to enter and abate the graffiti on my property. I understand that it is solely at the discretion of the SOMA West Community Benefit District, or its designee, as to what method or manner is used to abate the graffiti on my property and that the abatement will only occur on the area which the graffiti covers. I further understand that this may result in blocks or strips that do not match in color or sheen to the surrounding area. I hereby release the SoMa West Community Benefit District, employees and agents from any and all liability, claims, demands, causes of action or obligations whatsoever, know or unknown, directly or indirectly, arising out of or relating to entry to my property or the graffiti removal, including, without limitation, all liability claims, demands, causes of action or obligations including personal injury, death and property damage, the appearance or condition of the property after the cleaning or removal, or the use of photographs, videotapes or films of the property. I agree that in the event that I sell the property or am no longer the owner’s authorized representative, I will notify the SOMA West Community Benefit District within seven days. I intend that this consent continue indefinitely until revoked by sending written notice of the revocation to the SOMA West Community Benefit District. * *
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of SoMa West Community Benefit District.