SUBDIVISION/CONDOMINIUM APPLICATION

SCHEDULEE - Environmental Site Screening Questionnaire - Continued

Environmental Site Screening Questionnaire Acknowledgement Clause | hereby acknowledgethatit is my responsibility to ensure that | am in compliancewith all applicable laws, regulations, guidelines and the City’s Official Plan policies pertaining to potentially contaminated sites, and to use all reasonable effort to identify the potentialfor contamination on the subjectproperty.

| acknowledge that as a condition of approval of this application that the City may require me to file a Record of Site Condition signed by a qualified personin the provincial Environmental Site Registry, and provide verification to the Cily of Windsor of acknowledgementofthis Record of Site Condition by the Ministry of Environment.

| acknowledgethat the City may require the qualified person signing the Record of Site Condition to submitto the City a Declaration acknowledging that the City of Windsor mayrely on the statementsin the Record of Site Condition.

| further acknowledgethat the City of Windsoris not responsible for the identification and/or remediation of contaminated sites, and | agree, whetherin, through,or as a result of any action or proceeding for environmental clean-up of any damageorotherwise, | will not sue or make claim whatsoeveragainstthe City of Windsor,its officers, officials, employees or agents for or in respectof any loss, damage, injury or costs.

Nameof Applicant(print)

Signature of Applicant

END OF SCHEDULE E