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GRAFFITI REMOVAL REQUEST FORM
Your Information
Contact Name
Phone #
Email
Location of Graffiti
Street Address
City
Exact Location (on sign, on front of building etc)
Type of surface
For painted surfaces, can you supply matching paint?	YES NO
Agreement
I certify that I am the owner of the above property or have authorization from the owner to act on their behalf, or the location reported is on public property.
I have read and agree to the terms listed below. Graffiti removal agreement: Portland West shall use standard graffiti removal techniques (this may include use of solvents, pressure washing, sandblasting and paint over) available in the industry. Property Manager/Owner Representative waives any right or claim against Portland West, Portland’s Downtown District or the City of Portland and its representatives, officers, directors, employees, agents, successors and assigns arising out of, in connection with, or in any way related to the removal of graffiti from the above-referenced property. Portland West, Portland’s Downtown District or the City of Portland make no guarantee or warranties with regard to the quality of their workmanship, or the quality of the products used, to remove the graffiti from the above property.

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