EFTA01223480.pdf
dataset_9 pdf 2.8 MB • Feb 3, 2026 • 13 pages
LSJE, LLC
6100 Red Hook uarters. Suite B-3, St. Thomas, VI 00802-1348
Phon E-mail: thesaintjames.group@gmail.com
Subcontractor Employment Form
Today's Date: Start Date:
0-1) 0112110
Position/Title: Hourly Pay Rate:
Last Name:
E-14 NOE, First Name:
fiSk.;114
Nickname:
AL.,b Date of Birth:
13k Y1
Social Security Number: Driver's License Number
Mailing Address: Physical Address:
S91:34.. eyk
&AVv.t.ts • )5_
Cell Phone: Phone (other):
E-mail: Marital Status:
In case of emergency, please contact:
Contact:
1:214 Fit‘06 Relationship:
FOlitr
Contact Phone:
Supervisor Notes:
Proof of eligibility for employment is required. Please attach a.) a Photocopy of your US. Passoort or Pasipott Card OR
b.) a photo ID AND supporting documentation establishing U.S. Employment Authorization
Employee Signature: VI 11110 a po Date:
tx.u. QS IOMI
Supervisor Signature: Date:
EFTA01223480
LSJE, LLC
6100 Red Hook Quarters. Suite B-3, St. Thomas. VI 00802-1348
Phone: 340-775-2525 E-mail: thesaintjames.group@gmail.com
Emergency Contact Form
Today's Date:
,Jetxn Iwo\ Start Date:
Employee Name:
Physical Address:
Mailing Address:
Cell Phone:
E-mail:
Marital Status:
k
Title/Position:
Driver's License No:
Mae
Allergies or Health Concerns:
Blood type:
CI A- El A+ ❑AB- D O8- ❑ 8+ O O' El 0+ ❑ Unknown
Current Medications:
Doctors Name: Doctor's Phone:
Doctors Name: Doctor's Phone:
In case of emergency, please contact:
Name: Relationship: Phone:
Name: Relationship: Phone:
This information is for your safety and the safety of others.
EFTA01223481
FormW-9
Pm November 2c1„
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
Depatmen of theTreasury
In Revenue
t Sen1ce le Go to rinviv.irs.govam11011) for Instructions and the latest Information. send to the IRS.
1 S( tas shown en your income tax return). Name is required on ties One: do rot lea4e this line Clank.
-Ales VS;At d. it,
2 ea nemerthereganord entity name, If different from above
e 3 Check epprocdate box for federal text:testis:aeon of the person whose name ts entered on Ins 1. Check ort./ one of the 4 Exemptions (codes apply only to
folowing al boxes, certain entities, not individuals: see
a estructrons on page 3):
Indirlduallsole proprietor or 0 C Corporation 0 S Corporation 0 Partnership 0 TrustArstate
sngs-nwaw Lie
0
•2 Exempt payee code el are)
' 0 Uneled liability company. Ear IN. tax ctoosifeation (C C corporation, S- S corporation. P..Partneralle).
"
tr. Note: the* the aearoPerate box in the Free above for the tax classification of the Ungiememoer Oo not check Exemption from FATCA reponino
LLC It the ISO is clashed as a unglomembor LLC that n disregarded from the owner enures theowner. owner ol the LLC is ease (a any)
anOther US that is not disregarded from the owner for U.S. federal tax purposes. Otherwise. a single-member LW
Is demean:fed from the owner should check the opreopriate box for the tax clasarecatkel of Its owner. that
U Other (see instnathem)l. Wo&es pacoouts inakarro GSM OM U.SJ
Requester's name and address lePeene9
Ii 1 Taxpayer Identification Number (UN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Mel to avoid Social seCurity number
backup withholtfing. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
Note: If the account Is in more than one name, see the instructions for line 1. Also see What Name and Employer Identification number
Number To Give the Requester for guidelines on whose number to enter.
-
Part rtification
Under penalties of perjury. I certify that:
1. The number shown on this form is my coned taxpayer identification number (or I am wailing for a number
to be issued to me): and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, by the Internal Revenue
or (c) the IRS has notified me that I am
no longer subject to backup withholding: and
3. I am a U.S. citizen or other US. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I em exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently
subject to backup withholding because
you have failed to report all interest and dividends on your tax rotten. For real estate transactions, Item 2 does not apply. For mortgage
acquisition or abandonment of secured property. cancellation of debt, contributions to an incisidual retirement arrangement interest paid,
other than interest and dividends. you are not rock-wed to sir the certification, but you must provide your correct TIN. See the (IRA), and generally, payments
instructions for Part II, later.
Sign S.
Signature of
Here U person Date, UR
General Instructions • Form 1099-Die (dividends, including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise
noted. • Form 1099-MISC (various types of income, prizes, awards, or gross
Future developments. For the latest information about developments proceeds)
related to Form W-9 and its instructions, such as legislation enacted • Form 1099-B (stock or mutual fund sales and certain other
after they were published. go to www.irs.gov/FomiVV9. transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
Purpose of Form • Form 1099-K (merchant card and third party network transactions)
M Individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest). 1098-E (student loan interest),
Information return with the IRS must obtain you correct taxpayer 1O98•T (tuition)
identification number (i1N) which may be your social security number • Form 1099-C (canceled debt)
(SSN), individual taxpayer identification number OTIN), adoption • Form 1099-A (acquisition or abandonment of secured property)
taxpayer identification number (ATIN). or employer identification number
(EIN), to report on an information retum the amount paid to you. or other Use Form W-9 only h you are a U.S. person (including a resident
amount reportable on an information return. Examples of information alien), to provide your correct 11N.
returns Include, but are not limited to, the following. If you do not return Form W-9 to the requester with a TIN, you might
• Form 1099-INT (interest earned or paid) be subject to backup withholding. See What is backup withholding,
later.
Cat No. 10231x Form W-9 (Rev. 11-2017)
EFTA01223482
CONFIDENTIALITY AGREEMENT
In order to induce LSJE, LLC, a Virgin Island
s limited liability company (the
"Company"), to consider me for employment with the
Company or to consider engaging me as
an independent contractor of the Company, and in
consideration of any future employment or
engagement that I may obtain with the Company and any
compensation or other remuneration to
be hereafter paid to me in connection therewith, I,
c'kuut. (hereinafter sometimes
referred to as the Applicant"), acknowledg
e that I have been informed of my obligations
hereunder and that such obligations are a condition to
the Company's consideration of my
employment or engagement by the Company, and any
subsequent employment or engagement I
may obtain, and I hereby agree as follows:
Section 1. Term of Employment; Termination. In the event that
employed by the Company, notwithstanding anything I am hereafter
to the contrary provided in the Virgin
Islands employment law, I agree and understand
that nothing in this Agreement shall confer any
right with respect to the grant or continuation of
my employment by the Company. I further
agree and understand that, in the event that I am hereaf
ter employed or engaged by the Company,
any breach of this Agreement by me may result,
in addition to any and all other remedies which
may then be available to the Company, in my imme
diate termination.
Section 2. Confidentiality Obligations of the Applicant.
2.1 Definition of Confidential Information. (a) For purposes of this
Agreement, the term "Confidential Information" shall mean
any "Company Information" (as
hereinafter defined) and any "Personal Information" (as herein
after defined) about any one of (i)
Jeffrey Epstein, (ii) Little St. James Island and Great
St. James Island (the 'Property"). (iii) the
Company, any corporation, limited liability company, partne
rship or any other entity owned or
controlled by Jeffrey Epstein ("Affiliate"), or any of the memb
ers, managers, partners, directors,
officers, shareholders, or agents thereof, (iv) any other emplo
yee of the Company or any
Affiliate or any other person or entity employed or engag
ed to provide services on or with
respect to the Property, (v) any person visiting the Property or
any of the Company's offices, and
(vi) any personal associate, business associate or client of
any of the persons described in the
above clauses (i) through (v), inclusive, gathered
or learned by the Applicant directly or
indirectly during the course of the Applicant's application
for employment or engagement by the
Company and/or in connection with any employment or
engagement of the Applicant by the
Company.
(b) For purposes of this Agreement, the term "Company Information"
mean information about the Company of any type which shall
is commonly considered of a
confidential nature and includes, but is not limited to, information
(whether in oral, written,
photographic or recorded fonn) regarding the persons or entities
for who the Company provides
services; business plans; mechanized or nonmechanized system
s of accounting; methods or
procedures in conducting activities; drawings, plans, permi
ts or filings with respect to the
Property; vendor lists; assets; financial records; the identi
ties, skills, business activities,
compensation and financial net worth and any other information
of a similar nature about any of
the persons or entities described in clauses (i) through (vi),
inclusive, of Section 2.1(a) of this
EFTA01223483
Agreement (the "Classified Parties").
(c) For purposes of this Agreement, the term
"Personal Information" shall mean
information of any type which is commonly
considered of a personal nature and includes, but is
not limited to, information (whether in oral,
written, photographic or recorded form) regarding
the identities; the nonbusiness activities; person
al assets; personal plans; the personal lifestyle,
relationships, friends and relatives of, the individuals who assoc
iate with or who are invited to
associate with, and any other information of a similar nature
about any of the Classified Parties.
2.2 Confidential Information Shall Not Be Discussed.
hereafter. I will hold in the strictest confidence and will At all times
not use, publicize, lecture upon, publish
or in any manner disclose any Confidential Inform
ation, unless the Company has expressly
authorized in writing such disclosure, use or public
ation. I hereby assign to the Company any
rights I may have or acquire in any Confidential
Information and acknowledge that all
Confidential Information shall be the sole and exclusive
property of the Company. I further
agree and acknowledge that under this Agreement,
1 am obligated to use my best efforts to
ensure that no Confidential Information is disclosed. To
the extent that I have any doubts, either
now or in the future, as to whether information I possess is
Confidential Information as defined
herein. I will contact the Company for clarification before divulg
ing or using such information.
2.3 Third Party Information Shall Not Be Disclosed. I
may receive Confidential Information from third parties, as well understand that I
as from the Company. I
acknowledge and agree that Confidential Information which receiv
I e from third parties is to be
treated in the same manner as Confidential Information receiv
ed from the Company and that all
of my obligations hereunder apply to all Confidential Inform
ation received, regardless of its
source.
2.4 Return of Documents. Upon demand by the Company, will
the Company any and all documents, written materials, I deliver to
notes, drawings, photographs;
specifications and any other materials of any type or nature whats
oever which I have in my
possession or control, and all copies thereof, which may
constitute, include or disclose
Confidential Information.
Section 3. Review of Agreement. I acknowledge that I have
read this Agreement,
and that I have had the opportunity to consult and review it with
my own counsel if I so desire,
before signing it.
Section 4. Conflicts.
4.1 Avoidance of Conflict of Interest. I agree that during the term
employment or engagement of me by the Company, so long as 1 am emplo of any
yed or engaged on a
full-time basis, I will not, without the Company's express wrinen conse
nt, engage in any
employment or other business activity other than the performance of my
duties for the Company.
4.2 No Conflicting Obligations. I warrant and represent that I have not
entered into, and agree that I will not enter into, any agreement (either writte
n or oral) that
EFTA01223484
conflicts with the provisions of this Agr
eement or otherwise impairs my ability to
obligations hereunder. I further war perform my
rant and represent that I am not subject to
decree, writ or order of any court any injunction,
or to any other duty or responsibility, lega
conflicts with the provisions of this Agr l or otherwise, which
eement or otherwise impairs my ability
obligations hereunder. I shall immedia to perform my
tely inform the Company should I subs
subject to any such injunction, decree, equently become
writ, order, duty or responsibility.
Section 5. Remedies.
5.1 Equitable Relief. I acknowledge that the Confidential
constitutes unique and confidential info Information
rmation of the Company and the othe
and in the event of a breach or a thre r Classified Parties
atened breach of this Agreement, the Com
Classified Parties will be irreparably pany and the other
harmed and there will be no adequate
Therefore, in addition to any and remedy at law.
all other rights and remedies the Compan
Classified Parties may have, the y and the other
Company and the other Classified Parties
injunctive or other equitable relief shall be entitled to
in the event of a breach or threatened brea
hereby waive any right to assert as ch hereof and I
a defense that there is an adequate remedy at
law.
5.2 Liquidated Damages. In addition to
or damages available at law or in equity, any and all other rights, remedies
I agree that if any arbitrator(s) or a cour
jurisdiction finds that I have breached any t of competent
of the provisions of this Agreement,
Company the sum of One Hundred Tho I will pay the
usand (5100,000.00) Dollars, as liquidat
not as a penalty. I recognize and understa ed damages and
nd that it would be difficult or impossible
the actual amount of damages resulting to calculate
from such a breach, and acknowledge
One Hundred Thousand (5100,000.00) that the sum of
Dollars would be reasonable under the circ
umstances.
5.3 Enforcement by Other Classified Parties
and agree that each of the Classified Part . I understand, acknowledge
ies other than the Company is an intended
beneficiary of Section 2 and Section 5.1 third party
of this Agreement and that each of them shal
right to enforce my obligations hereund l have the
er in an action brought in his, her or its own
name.
Section 6. General Provision.
6.1 Governing Law. This Agreement shal
in accordance with the laws of the United l be governed by and construed
States Virgin Islands applicable to contrac
delivered and to be fully performed in such ts executed,
jurisdiction, without giving effect to the prin
conflicts of law. ciples of
6.2 Severability. If one or more of the provisions of this
deemed invalid or unenforceable by law, then Agreement are
the remaining provisions hereof will con
full force and effect, without regard to tinue in
the invalid or unenforceable provision or
hereof, as the provisions of this agreement provisions
are intended to be and shall be deemed seve
rable.
6.3 Survival. The provisions of this Agreem
ent shall continue in full force
3
EFTA01223485
and effect, regardless of whether
the Applicant is ultimately employed
Company, and if the Applicant is emp or engaged by the
loyed or engaged by the Company, the
shall survive the termination of provisions hereof
any such employment or engagement
Company. of the Applicant by the
6.4 Binding Effect. This Agreem
binding upon, and inure to the bene ent and all of the provisions hereof
fit of, the parties hereto and thei shall be
assigns, heirs and personal repr r respective successors,
esentatives.
6.5 Waiver. No waiver by the Compan
shall be a waiver of any precedin y of any breach of this Agreement
g or succeeding breach. No waiver by
right under this Agreement shall be the Company of any
construed as a waiver of any other righ
not be required to give notice to enfo t. The Company shall
rce strict adherence to all of the terms and
Agreement. provisions of this
6.6 Headings. The headings contained
shall not control or effect in any way the herein are for convenience only and
meaning or interpretation of the provisio
ns hereof.
6.7 Entire Agreement. This Agreement
understanding between the Company and sets forth the entire agreement and
the Applicant relating to the subject mat
supersedes and merges all prior discussions, ter hereof and
understandings and agreements, whether
oral, between them relating to the subj written or
ect matter hereof. No modification
this Agreement, nor any waiver of of, or ame ndment to,
any rights under this Agreement, will
writing signed by the party to be char be effective unless in
ged therewith. If the Applicant is
engaged by the Company, any terms of emp hereafter employed or
loyment or statements of employment
by the Applicant, and any subsequent chan policy signed
ge or changes in the Applicant's duties,
remuneration will not affect the validity salary or other
or scope of this Agreement.
Signed: 1.41.
Print g
Name: NV, At; Ct &wt..
Date: Sour. ;614
Address:1MM'.
EFTA01223486
ACKNOWLEDGEMENT, ASSUMPTION OF RISK, WAIVER, RELEASE AND
INDEMNITY
THIS ACKNOWLEDGEMENT, ASSUMPTION OF RISK, WAIVER, RELEASE,
AND INDEMNITY dated Ofrkt./. I. 201q.
By:
(Print Name and Address)
(the undersigned, together with all of the past, present and future directors, officers,
managers, employees, subcontractors, representatives and agents of the
undersigned, are hereinafter referred to, collectively, as "I" , "me" or "my") in favor
of the Indemnified Persons (as defined below).
WHEREAS, I desire to be engaged as a vendor, supplier and/or an
independent contractor of one or more of Nautilus, Inc., LSJE, LLC, Great St. Jim, LLC,
Jeffrey Epstein, and/or other corporations, limited liability companies or entities
affiliated with any of the foregoing (hereinafter referred to as "you" or "your"), to
provide services and/or provide and/or install products, materials, machinery,
equipment for, on or with respect to either or both of the properties located at and
known as Little St. James Island and Great St. James Island (the "Properties"), all as
more particularly described on Exhibit A hereto (the "Work"); and
WHEREAS, my actions in connection with such engagement, my travel to and
from the Properties and my physical presence on the Properties may cause me to
engage in Inherently Dangerous Activities (as defined below) and expose me to
Inherently Dangerous Conditions (as defined below); and
WHEREAS, as a material inducement and an express condition precedent for
you to consider me for such engagement, and to so engage me, and in consideration
of any such engagement that I may obtain from you, I have agreed to assume the risk
of, to waive, and to Release, indemnify and hold harmless the Indemnified Persons
(as defined below) from and against, any and all past, present and future claims in
any way arising out of, related to or connected with, any and all past, present and
future damage and/or destruction to personal property, any and all past, present
This document is confidential and is intended only for the use of the authorized recipient. It is the property of LSJE,
LLC Unauthorized sse, disclosure or copying of this document or any part thereof is strictly prohibited and
may be
unlawful. O2017 LSJE. LLC - All rights reserved.
1
EFTA01223487
and future personal injuries, and/or my death in connection with such engagement,
my past, present and future travels to and from the Properties, my past, present and
future physical presence on the Properties, my past, present and future exposure
to
any and all Inherently Dangerous Conditions, my past, present and future
participation in any and all Inherently Dangerous Activities or any other
past,
present and future acts or omissions on or with respect to the Properties;
NOW, THEREFORE, in consideration of the foregoing premises, and for other
good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged by me, I, intending to be legally bound, hereby agree as follows:
1. ACKNOWLEDGEMENT. I understand and acknowledge that the
Properties, including, but not limited to, the pathways, roadways, docks, riprap,
buildings, structures, improvements, landscape, topography, hardscape, ponds, falls,
shores, surrounding waters, and other features thereof, both natural and man made,
may contain defects, both hidden and obvious, and "attractive nuisances,"
vegetation, animals and other conditions ("Property Conditions"), and that there are
used on the Properties tools, equipment, machinery, chemicals, and other materials
as a material part of the conduct of normal operations on the Properties ("Property
Equipment and Material?), and that such Property Conditions and Property
Equipment and Materials may be dangerous to my person and property ("Inherently
Dangerous Conditions"). I further understand and acknowledge that in connection
with my present and future engagement, my past, present and future travel to and
from the Properties, and my past, present and future physical presence on the
Properties, I may have been and may be required to engage in activities that
exposed or will expose me to such Property Conditions, and required or may require
my use of such Property Equipment and Materials, and that such activities may be
dangerous to my person or property ("Inherently Dangerous Activities"). 1 further
acknowledge, agree and represent that I fully understand the nature of the
Inherently Dangerous Conditions previously, presently or hereafter on the
Properties and the nature of any Inherently Dangerous Activities that I have
undertaken or may undertake, and that I am in good heath and in proper physical
condition to bear the risk of exposure to such Inherently Dangerous Conditions and
to engage in any such Inherently Dangerous Activities. I further agree that it is and
shall be my sole responsibility to, and I shall, obtain and maintain my own liability
insurance policies for the work, naming you as an additional insured, in such
amounts as we shall mutually agree, and I have obtained and shall obtain and
maintain workman's compensation insurance for my employees, in such amounts
and with such coverages as are required by law, to insure against past, present and
future damage and destruction to personal property, and past, present and future
personal injury or death to my subcontractors and direct and indirect employees
who have provided or may hereafter provide the Work.
2. ASSUMPTION OF THE RISK. I fully understand that (a) my
present and future engagement by you to provide the Work, my past, present
This docurnent is confidential and is intended only for the use of the authorized recipient. It is the property of LSJE.
LLC Unauthorized use, disclosure or copying of this document or any part thereof Is strictly prohibited and may be
unlawful. 02017 LSJE. LLC • All rights reserved.
2
EFTA01223488
and future travel to and from the Properties, my past, present and future
physical presence on the Properties, my past, present and future exposure to
any Inherently Dangerous Conditions and my past, present and future
engagement in any Inherently Dangerous Activities INVOLVES RISKS AND
DANGERS of serious bodily injury, including permanent disability, paralysis
and death ("Dangers"); (b) these Dangers may have been or may be caused by
my own actions or inactions, the actions or inactions of others, the conditions
existing at the time that the Dangers occur, or the negligence of one or more
Indemnified Persons; and (c) there are or may be other risks, damages and
losses either not known to me or not readily foreseeable at this time; and I
FULLY ACCEPT AND ASSUME ALL SUCH DANGERS AND RISKS AND ALL
RESPONSIBILITY FOR ALL LOSSES, COSTS, AND DAMAGES that may have been
and may hereafter be incurred by me as a result of or in connection with the
Properties, my present or future engagement by you to provide the Work, my
past, present and future travel to and from the Properties, my past, present
and future physical presence on the Properties, my past, present and future
exposure to any Inherently Dangerous Conditions and my past, present and
future engagement in any Inherently Dangerous Activities. I fully understand
and agree that I HAVE BEEN, AM AND SHALL BE FULLY RESPONSIBLE FOR MY
OWN SAFETY WHILE ON THE PROPERTIES. I expressly agree to assume the
risk and liability that I have suffered or may suffer, directly or indirectly,
injury, including, but not limited to, total loss or destruction, to my property
or personal injury, including, but not limited to serious bodily harm or death,
whether due to some Inherently Dangerous Condition, Inherently Dangerous
Activity or otherwise, whether known or unknown to you, or any owner,
shareholder, member, director, officer, manager, supervisor, employee,
representative, attorney, contractor or agent of you (you, together with all
such owners, shareholders, members, directors, officers, managers,
supervisors, employees, representatives, attorneys, contractors and agents of
you, collectively, the "Indemnified Person?), whether disclosed or not
disclosed to me, and whether or not caused by any act of negligence of any
Indemnified Person, as long as such acts do not constitute willful and wanton
misconduct
3. CAREFUL INSPECTION. I agree, represent and warrant that I will
carefully consider and inspect each Inherently Dangerous Condition to which I am
exposed and each Inherently Dangerous Activity in which I take part, and that, if I
observe any condition which I consider to be unacceptably hazardous or dangerous,
I will notify you in writing regarding the same and will not take part in such
unacceptably hazardous or dangerous activity until the condition has been
corrected.
4. WAIVER AND RELEASE OF CLAIMS. I hereby waive, and release,
acquit and forever discharge each and all of the Indemnified Persons from all
liability for, any and all past, present and future claims, demands, losses, or
This document is confidential and is intended only for the use of the authorized recipient. It is the property of LSJE,
LLC Unauthorized use, disclosure or copying of this document or any part thereof is strictly prohibited and may be
unlawful. O2017 LSJE, LLC - All rights reserved.
3
EFTA01223489
damages previously, now or hereafter arising out of, relating to, or connected
with, the Properties, my present and future engagement by you to provide the
Work, my past, present or future travel to and from the Properties, my past,
present or future physical presence on the Properties, my past, present or
future exposure to any Inherently Dangerous Conditions and my past, present
or future engagement in any Inherently Dangerous Activities, including, but
not limited to, any and all claims, demands, losses, or damages for past,
present and future loss or destruction, to my property or for any past, present
and future serious bodily harm or death, and including, but not limited to, any
and all claims, demands, losses or damages arising out of the past, present and
future negligence of any of the Indemnified Persons (hereinafter referred to
as "Released Claims").
S. COVENANT NOT TO SUE. I hereby expressly covenant not to sue
or initiate, prosecute, participate in or otherwise pursue any claim or cause of
action against any of the Indemnified Persons arising out of or relating to any
Released Claim, whether past, present or future.
6. INDEMNIFICATION. To the fullest extent permitted by law, I shall
1 defend, indemnify and hold harmless each and all of the Indemnified Persons
from any and all claims, actions and/or damages in any way arising out of,
relating to, or connected with any and all matters, whether past, present or
future, within the scope of any Released Claims, whether such claims, actions
and/or damages are asserted by me or any third parties, including, without
limitation, for past, present and future bodily injury and property damage, as
well as for attorneys fees and costs of you. This indemnity shall constitute a
waiver of any immunity conferred by any applicable workers compensation
laws.
7. ADDENDA. I shall cause each and every one of the subcontractors of
the undersigned and each and every one of the direct or indirect employees of the
undersigned who may provide the Work to agree in writing to be subject to, and
bound by, the provisions of this instrument for the benefit of the Indemnified
Persons, as if such subcontractor or employee was an original signatory hereto, by
signing an Addendum in the form of Exhibit B attached hereto.
8. THIRD-PARTY BENEFICIARIES. I hereby acknowledge and
expressly agree that the provisions of this ACKNOWLEDGEMENT, ASSUMPTION OF
RISK, WAIVER, RELEASE, AND INDEMNITY shall be fully enforceable against me by
any of the Indemnified Persons, each of whom is hereby expressly deemed to be an
intended third-party beneficiary hereof.
9. GOVERNING LAW. This ACKNOWLEDGEMENT, ASSUMPTION OF
RISK, WAIVER, RELEASE, AND INDEMNITY shall be governed by, and construed in
accordance with, the laws of the United States Virgin Islands, applicable to contracts
This document is confidential and is intended only for the use of the authorized recipient. II is the property of LSJE,
LW Unauthorized use, disclosure or copying of this document or any part thereof is strictly prohibited and may be
unlawful. m 2017 LSJE. LLC - All rights reserved.'
4
EFTA01223490
executed and to be performed entirely therein without applicatio
n of any principles
of conflicts of laws.
[SIGNATURE ON THE NEXT PAGE]
IN WITNESS WHEREOF, the undersigned has caused this Agre
ement to be
executed as of the day and year first above written.
Name: k ikeutt, ti sit!)
Name and Title, if any, of Authorized Signatory:
Signature:
This document is confidential and Is intended only for the use of the
authorized recipient. It is the property of LSJE,
LLC Unauthorized use, disclosure or copying of this document or any
part thereof is strictly prohibited and may be
unlaveful. 02017 LSJE, M rights reserved.
5
EFTA01223491
EFTA01223492
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