Security Video Release Form

SECURITY VIDEO RELEASE AGREEMENT

Parties

Requesting Party:

Custodian of Record (Provider):

Recitals

WHEREAS, the Custodian of Record maintains security camera recordings and related metadata for the premises identified in this Agreement and is authorized to retain and produce such recordings in accordance with applicable law; and

WHEREAS, the Requesting Party has requested access to specified security video recordings for the limited purpose described in this Agreement and agrees to compensate the Custodian for reasonable reproduction and handling costs; and

WHEREAS, the parties desire to set forth the terms and conditions under which the Custodian will produce and the Requesting Party will receive copies of the recordings, including restrictions on use, confidentiality, and indemnity obligations.

Scope of Work

Video Identification

Premises/Location:

Camera ID(s) / Description:

Incident Date(s):    From Time:    To Time:

Authorization and Release

The Requesting Party hereby authorizes the Custodian to reproduce and release the recordings described above to the Requesting Party or its authorized representative. The Requesting Party affirms that the requested footage will be used solely for the purpose stated in this Agreement and will not be further disseminated except as required by law or court order. The Requesting Party acknowledges that certain portions of recordings may contain the images of third parties and that the Custodian's obligation to produce footage may be limited by privacy laws and internal policy.

The Requesting Party agrees to indemnify, hold harmless and defend the Custodian and its employees, agents and contractors from any claims, liabilities, losses, or expenses (including reasonable attorneys' fees) arising from the release, possession, use, or dissemination of the released recordings by the Requesting Party or its agents.

Payment Terms

Reproduction Fee (per hour or per incident): $

Delivery/Processing Fee: $

Late Fee:

Term and Termination

Effective Date:    Termination Date (if applicable):

Either party may terminate this Agreement for convenience by providing written notice to the other party at least days prior to termination. Termination will not relieve the Requesting Party of payment obligations for services performed prior to termination.

Confidentiality

The Requesting Party acknowledges that the released video may be confidential or contain private information. The Requesting Party agrees to maintain the confidentiality of the footage and not to disclose, publish, post, or otherwise disseminate the footage except to attorneys, insurers, governmental authorities, or as required by law. Any permitted disclosure must be on a strictly need-to-know basis and, where practicable, accompanied by notice to the Custodian.

Acknowledgement of Confidentiality: I agree to the confidentiality obligations set forth above.

Chain of Custody and Handling

The Custodian will document chain of custody and will provide a written record of reproduction and transfer upon request. The Custodian does not warrant the completeness or continued availability of recordings beyond retained archives and will not be responsible for degradation of footage resulting from storage or transfer beyond commercially reasonable steps taken at the time of reproduction.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles.

Entire Agreement

This Agreement, including any written attachments executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, negotiations, and communications, whether oral or written. No amendment or waiver of any provision of this Agreement will be effective unless in writing and signed by both parties.

Miscellaneous Provisions

If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions will remain in full force and effect. Neither party may assign this Agreement without the prior written consent of the other, except the Custodian may assign to an affiliate that assumes its obligations hereunder.

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