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Cities of Dublin and Pleasanton | Disaster Debris Management Plan | 2022 190 Attachment M: Sample Right of Entry Permit RIGHT-OF-ENTRY PERMIT [For Providing Debris Removal on Private Property] <Insert name of owner> (“Owner”), hereby permits the City of ____________ its officers, employees, agents, contractors and subcontractors (“City”), to enter upon Owner’s property commonly identified as <insert property address>, County of Alameda, State of California (“Premises”), subject to all licenses, easements, encumbrances, and claims of title affecting the Premises upon the following terms and conditions: 1. Grant of Right of Entry. Owner hereby grants the City a right of entry (“Permit”) over the Premises for the purpose of inspecting the Premises, testing materials on the Premises, removing and clearing any or all <name of incident> generated debris of whatever nature including by not limited to ash, vehicles, construction debris, trees, waste or other materials from the Premises, subject to the terms and conditions set forth in this Permit. It is fully understood that this Permit does not create any obligation on the City to perform inspection, testing or debris clearance. Owner understands that the City will undertake no cleanup action until the Right-of-Entry Permit is signed and returned. 2. Private Insurance Coverage. Most homeowner’s insurance policies have coverage to pay for the costs of removal of <insert type of incident> generated debris. Owner understands that in the event federal financial assistance is received by the Owner for purposes of inspection, testing or debris removal hereunder, federal law (42 United States Code 5155, et seq.) requires Owner to reimburse the City for the cost of removing <insert name of incident> generated debris to the extent covered in Owner’s insurance policy. Owner also understands that, when requested, Owner must provide a copy of the insurance policy, proof/statement of loss and settlement agreement from Owner’s insurance company to the City. Owner (_____does, ____ does not) have homeowners or similar insurance. If Owner indicates that Owner does not have such insurance, Owner certifies under penalty or perjury that there was no insurance in effect at the time of the <insert type of disaster>, which may provide coverage for the costs of inspection, testing or debris removal. 3. Duplication of Benefits. Owner (____ has, ____ has not) and (____ will, ____ will not) receive(d) any compensation for debris removal from any other source including Small Business Administration (SBA), individual and family grant program or any other public assistance program. Owner will advise the City in writing within 10 days of receipt of any insurance settlements for debris removal. Owner further agrees to reimburse the City within 30 days of receipt, from such proceeds, for the cost of the debris removal conducted by the City. In the event the insurance proceeds are less than the cost of debris removal incurred by the City, Owner will not be responsible for the difference. If the insurance proceeds exceed the City’s cost of debris removal,