PUBLIC UTILITY EASEMENT Project ____________________________________________________________ Project No _________________________________ THIS INDENTURE

PUBLIC UTILITY EASEMENT Project: ____________________________________________________________ Project No. _________________________________ THIS INDENTURE, made this _______ day of _________________________________ A.D., 20___, between _________________________________________________________________, whose address is __________________________________________________________________, Party of the First Part, and the CITY OF MELBOURNE, a Municipal Corporation whose address is 900 East Strawbridge Avenue, Melbourne, Florida 32901, County of Brevard, State of Florida, Party of the Second Part, Wherever used herein the terms Party of the First Part and Party of the second part include the singular and plural forms and the masculine and feminine gender. WITNESSETH, that the said party of the first part, for and in consideration of the sum of One Dollar ($1.00) and other valuable considerations to him in hand paid by the party of the second part, the receipt whereof is hereby acknowledged, has remised, released and by these presents does grant and convey to the said party of the second part, its successors and assigns, an easement for public utilities for the City of Melbourne, County of Brevard, State of Florida, described as follows, to wit: SEE ATTACHED EXHIBIT “A” This easement is made for the purpose of giving and granting to the party of the second part, its successors, legal representatives and assigns, an easement in, to and across said lands for the purpose of maintaining public utilities, together with the right of ingress and egress for such purposes. And the said party of the first part does hereby fully warrant the title to said lands, and will defend the same against the lawful claims of all persons, whomsoever. Page 1 of 2 IN WITNESS WHEREOF, the said Party of the First Part has hereunto set his hand and seal this day and year first above written. Signed, sealed and delivered in the presence of: (SEAL) Signature of Witness Signature of Party of First Part Name Printed/Typed ____________________________________ Signature of Witness Name Printed/Typed & Title Name Printed/Typed STATE OF COUNTY OF The foregoing instrument was acknowledged before me this day of , 20___, by ____________________________________________________________________________ who is personally known to me OR who has produced __________________________________ as identification and who did (or did not) take an oath. _________________________________________ Notary Public _________________________________________ Printed/Typed Name of Notary Public My commission expires: (Printed/Typed Name of Party of First Part) Page 2 of 2

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