SHORT FORM While supplies last, buy any of the participating products in a single transaction from a Northgate Gonzalez Markets store between 1/18/2017 and 2/07/2017 and receive one Char-Griller Duo Black Dual-Function Combo Grill. Limit 1 ticket per participant. Participants must be at least 21 years old and a resident of California to receive a ticket. We reserve the right to limit ticket quantities per individual. Refunds on participating items are not allowed. Proof of eligibility may be required. Void where prohibited. Certain restrictions apply. By accepting a ticket, customer agrees to be bound by the complete terms and conditions, which are available at each Northgate Gonzalez Markets store and online at www.northgatemarkets.com. Tickets are subject to availability and only available at each Northgate Gonzalez Markets store while that store s supply lasts.
AFFIDAVIT OF ELIGIBILITY AND RELEASE NORTHGATE GONZALEZ MARKETS SWEEPSTAKES I, certify that: (Print Full Name) 1. All of the statements set forth in this Affidavit of Eligibility and Release ( Affidavit ) are true, correct, accurate, and complete to the best of my knowledge. 2. I am submitting this Affidavit with the understanding that it will be relied upon to determine my eligibility in the Northgate Gonzalez Markets Grill Giveaway Sweepstakes ( Sweepstakes ). 3. I am at least 21 years old. My birth date is:. 4. I am a resident of Los Angeles County, Orange County, or San Diego County. My address is:. 5. I have read, I understand, and I agree that I am bound by the Official Rules of the Sweepstakes, a copy of which is attached as Exhibit A and incorporated into this Affidavit by this reference ( Official Rules ). 6. I have complied with the Official Rules, and I have not committed any fraud or deception in connection with the Sweepstakes. 7. I have received one Char-Griller Duo Black Dual-Function Combo Grill (the Prize ). 8. I am solely responsible for any and all tax consequences arising out of or relating to my receipt of the Prize. I understand that my winning and acceptance of the Prize will be reported as required by law, which may require the completion and submission of an IRS Form 1099. I will execute an IRS Form W-9 concerning the Prize if Northgate Gonzalez, LLC, a California limited liability company ( Sponsor ), requests that I do so. 9. I shall defend, indemnify, and hold harmless Sponsor and Sponsor s officers, directors, managers, employees, attorneys, agents, affiliates, subsidiaries, predecessors, successors, and assigns ( Promotion Parties ) from and against any and all claims, causes of action, liabilities, damages, costs, and expenses (including attorney s fees) of any nature, including direct claims and damages, (collectively, Claims ) arising out of or relating to: (i) my participation in this Sweepstakes; (ii) my acceptance, use, or misuse of the Prize (including claims for personal injury, death, and/or property damage); (iii) any false, misleading, or inaccurate certification or statement made by me in this Affidavit; or
(iv) my breach of any agreement or covenant made in this Affidavit, including the Official Rules. 10. In no event will the Promotion Parties, or any of them, be liable or responsible for any losses or damages of any kind, including direct, indirect, incidental, consequential, or punitive damages arising out of or relating to: (i) my participation in this Sweepstakes; or (ii) my acceptance, use, or misuse of the Prize (including claims for personal injury, death, and/or property damage). I acknowledge that Sponsor and the other Promotion Parties are not responsible if any Prize is lost, stolen, destroyed, or used without permission and that if a Prize is lost or stolen, it will not be replaced. 11. I, on behalf of myself and my heirs, assigns, executors, administrators, and any others who may claim by or through me, waive, release, and forever discharge the Promotion Parties, and each of them, from all Claims I have or may have arising out of or relating to: (i) my participation in this Sweepstakes; (ii) my acceptance, use, or misuse of the Prize (including claims for personal injury, death, and/or property damage); or (iii) my rights of publicity, rights of privacy, or moral or artistic rights relating to the License or the Materials (as those terms are defined in the Publicity Release Section of this Affidavit). I disclaim and waive all rights under California Civil Code Section 1542 and any similar law of any other state or jurisdiction. Section 1542 states: A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR. 12. In consideration for receiving the Prize, I hereby grant to Sponsor an irrevocable, royaltyfree, license to use my name, likenesses, and image throughout the universe in all types of media now or hereafter existing for purposes relating to Sponsor s advertising, marketing, and publicity for a period of eighteen (18) months from the date of my signature below ( License ). I agree that Sponsor will be the sole and exclusive owner of all worldwide rights, titles, and interests related to any materials created in connection with the License, including any advertisements, photographs, and news releases ( Materials ). I agree that Sponsor has all rights regarding the Materials, including the rights to modify, reproduce, display, create derivate works from, publish, and disseminate the Materials. I understand that I will not receive any additional compensation in connection with the License or the Materials. 13. I consent to the use of any information I provide to Sponsor in connection with Sponsor s marketing programs and to the terms of Sponsor s privacy policy, which may be found at: http://www.northgatemarkets.com/en-us/privacy-policy/. I acknowledge that I may opt-out
of receiving Sponsor s marketing materials at any time in the manner provided for in Sponsor s privacy policy. 14. This Affidavit (including the Official Rules) sets forth the complete understanding and agreement between Sponsor and me regarding the Sweepstakes, the Prize, the License, and the Materials and supersedes all other prior or contemporaneous agreements and understandings between us regarding those subjects. In the event of a conflict between this Affidavit and the Official Rules, the terms of this Affidavit will control. 15. If any statement or representation made by me in this Affidavit is discovered or reasonably believed by Sponsor to be false or misleading, I will return the Prize to Sponsor immediately upon demand. 16. I fully and completely understand all of the terms of and statements in this Affidavit and sign it voluntarily, freely, and knowingly. I understand that my execution of this Affidavit is a condition to my acceptance of the Prize, but that I am not required to accept the Prize. DATE: Print Name: OFFICIAL RULES
FOR NORTHGATE GONZALEZ MARKETS GRILL GIVEAWAY SWEEPSTAKES The following are the official rules, terms and conditions ( Official Rules ) of the Northgate Gonzalez Markets Grill Giveaway Sweepstakes ( Sweepstakes ). While supplies last, buy any of participating product in a single transaction from a Northgate Gonzalez Markets store between 1/18/2017 and 2/07/2017 and receive one (1) Char-Griller Duo Black Dual-Function Combo Grill (Item # 5050 Model # 5050), Liquid propane gas grill with charcoal grill on the same cart for duel fuel cooking, 1,260-sq in total cooking area: 876-sq in primary and 384-sq in warming rack, three durable stainless steel main burners; one 12,000-BTU side burner with flip-down cover. Assembly is NOT included. Propane gas and refills of same are NOT included. The Sweepstakes begins at 12:00 AM PST on January 18, 2017 and ends at 11:59 PM PST on February 7, 2017 ( Sweepstakes Period ). The odds of winning depend upon the number of Entries (as defined below). By participating in the Sweepstakes, participating persons ( Entrants ) agree to be bound by these Official Rules. The Sweepstakes is subject to all applicable federal, state, and local laws and is void outside of the Northgate Markets Geographic Area (as defined below) and where prohibited. This Sweepstakes is sponsored by Northgate Gonzalez, LLC ( Northgate ), 1201 N. Magnolia Avenue, Anaheim, California 92801. To enter the Sweepstakes, during the Sweepstakes Period, Entrants must complete the entry form ( In-Store Entry Form ) automatically generated when any of the participating products (excluding alcohol, tobacco, and milk) is purchased in a single transaction during the Sweepstakes Period at any participating Northgate Gonzalez Markets store operated by Northgate located in the counties of Los Angeles, Orange, or San Diego in the state of California (collectively, the Northgate Markets Geographic Area ). The completed In Store Entry Form must be submitted to the sweepstakes entry collection box at the store s Customer Service Desk. Entrants desiring to enter the Sweepstakes without purchase may send 3x5 inch cards stating their names, addresses, and phone numbers to Northgate Gonzalez, LLC, Attn: Marketing Department, Grill Giveaway Sweepstakes, 1201 North Magnolia Avenue, Anaheim, California 92801 ( Mail-In Entry Form, and together with In-Store Entry Forms, referred to individually as an Entry or collectively, Entries ). All Entries become the property of Northgate and will not be acknowledged or returned. All Entries must be received before 11:59 PM, PST on February 7, 2017 to be eligible for the Sweepstakes. Limit one (1) Entry per person during the Sweepstakes Period. Multiple Entries received from any person or address beyond this limit will void all such additional Entries. Entries that are incomplete, garbled, corrupted, or unintelligible for any reason are void and will not be accepted. On or about February 8, 2017, forty-one (41) winners (each a Winner ) will be selected in a random drawing by representatives of Northgate from all eligible Entries received during the Sweepstakes Period. The prize package ( Prize Package ) consists of:
1. One (1) Char-Griller Duo Black Dual-Function Combo Grill (Item # 5050 Model # 5050), Liquid propane gas grill with charcoal grill on the same cart for duel fuel cooking, 1,260- sq in total cooking area: 876-sq in primary and 384-sq in warming rack, three durable stainless steel main burners; one 12,000-BTU side burner with flip-down cove. The Prize Package is subject to certain terms and conditions and subject to availability. Restrictions apply. The Estimated Retail Value ( ERV ) of the Prize Package is Two Hundred Ninety-Nine Dollars ($299.00) per Winner. The Actual Retail Value ( ARV ) of the Prize Package may vary. Any difference between stated ERV and ARV will not be awarded. Any valuation of the prizing stated above is based on available information provided to Northgate and the value of any prize awarded to a Winner may be reported for tax purposes as required by law. All taxes and other expenses, costs, or fees associated with the acceptance and/or use of Prize Package are the sole responsibility of Winner. All details of Prize Package will be determined by Northgate in its sole and absolute discretion. Northgate reserves the right to substitute a similar Prize Package (or Prize Package element) of comparable or greater value for any reason at its sole and absolute discretion. Prize Package cannot be transferred by Winner or redeemed for cash and is valid only for the items detailed above, with no substitution of Prize Package by Winner. Each Winner must be at least twenty-one (21) years of age or older at the start of the Sweepstakes Period and a resident physically located and residing in the Northgate Markets Geographic Area. Employees of Northgate and members of their families (spouses and/or parents, children, and siblings, and their spouses, regardless of where they reside), and/or persons living in the same households as these persons (whether or not related thereto) are not eligible to enter or win the Sweepstakes. Northgate will make two (2) attempts to notify each Winner by telephone between February 8, 2017 and February 9, 2017 and each Winner will have twenty-four (24) hours after receiving notification to acknowledge that they have won. Acknowledgements must be made in the manner directed by Northgate in its notification. Each Winner will be deemed to have received notification that they have won on the day Northgate contacts such Winner by telephone. Each Winner must claim its Prize Package in the manner directed in the notification within two (2) days after acknowledging that they have won. The failure to claim a Prize Package within this two (2) business day period may result in disqualification without notice, and an alternate Winner may be chosen at Northgate s sole discretion. Each Winner will be required to present valid identification showing his or her age and place of residence at the time Prize Package is claimed. Each Winner may be required to execute an Affidavit of Eligibility and Release of Liability and a Publicity Release in order to claim a Prize Package. By accepting a Prize Package, each Winner consents to permission (except where prohibited by law) allowing Northgate to use such Winner s name, city, state, likeness, image, and/or voice for purposes of advertising, promotion, and publicity in any and all media now or hereafter known, throughout the world for a period of eighteen (18) months after the end of the Sweepstakes Period, without additional compensation, notification, permission, or approval.
By participating in the Sweepstakes, Entrants consent to the use of any information they provide to Northgate in connection with Northgate s marketing programs and to the terms of Northgate s privacy policy, which may be found at: http://www.northgatemarkets.com/en-us/privacy-policy/. As explained in Northgate s privacy policy, Northgate does not sell or rent any Entrant s personal information to unaffiliated third parties, and Entrant may opt-out of receiving Northgate s marketing materials. Communications regarding Northgate s marketing materials or privacy policy should be directed to: Privacy@NorthgateMarkets.com or Northgate Gonzalez, LLC, Attn: Northgate Customer Service Center, 1201 N. Magnolia Avenue, Anaheim, California 92801. Each Entrant in the Sweepstakes and such Entrant s heirs, executors, and administrators agrees to defend, indemnify, and hold harmless Northgate, Northgate s affiliates, and their respective officers, directors, managers, employees, attorneys, agents, affiliates, predecessors, successors, and assigns ( Promotion Parties ) from and against any and all liability or damages associated with the Sweepstakes or the acceptance, use, or misuse of any Prize Package (or Prize Package element) received in the Sweepstakes; and hereby releases and forever discharges and waives any claims against Promotion Parties arising out of or relating to the Sweepstakes or the acceptance, use, or misuse of any Prize Package received in the Sweepstakes. To the fullest extent permitted by law, Northgate hereby disclaims any and all errors, including typographical errors, omission, interruption, deletion, defect, delay in operation, theft or destruction or unauthorized access to, or alteration of, Entries, or any other problems in connection with the Sweepstakes, including but not limited to, technical malfunction in the posting of the rules online, cancellation, rescheduling, or delay of delivery of the Prize, incorrect or inaccurate information, whether caused by Entrants, printing errors, or any equipment programming, technical and/or communication malfunctions, unauthorized human intervention in any part of the Sweepstakes, or for any injury or damage to persons or property which may be caused, directly or indirectly, in whole or in part, from Entrant's participation in the Sweepstakes or receipt or use or misuse of any Prize Package. If for any reason an Entrant's entry is confirmed to have been erroneously deleted, lost, or otherwise destroyed or corrupted, Entrant's sole remedy is another entry in the Sweepstakes, provided that if it is not possible to award another entry due to discontinuance of the Sweepstakes, or any part of it, for any reason, Northgate, at its discretion, may elect to hold a random drawing from among all eligible entries received up to the date of discontinuance for any or all of the Prize Package offered herein. No more than the stated number of prizes will be awarded. In the event that production, technical, seeding, programming or any other reasons cause more than stated number of prizes as set forth in these Official Rules to be available and/or claimed, Northgate reserves the right to award only the stated number of prizes by a random drawing among all legitimate, unawarded, eligible prize claims. Any trade names, trademarks or service marks shown as part of the materials associated with the Sweepstakes are the property of their respective owners. To the fullest extent permitted by law, NORTHGATE HEREBY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING THE WARRANTIES OF MERCHANTABILITY AND
FITNESS FOR A PARTICULAR PURPOSE, RELATED TO ANY PRIZE PACKAGE RECEIVED IN THE SWEEPSTAKES. ALL PRIZE PACKAGES WILL BE PROVIDED AS-IS, WHERE-IS, AND WITH ALL FAULTS, AND SPONSOR MAKES NO REPRESENTATIONS OR WARRANTIES AS TO THE QUALITY, FITNESS, WORKMANSHIP, VALUE, LEGALITY, APPROPRIATENESS, OR RELIABILITY OF ANY PRIZE PACKAGE. Northgate is not responsible for Sweepstakes materials or Entry that is lost, late, misdirected, stolen, illegible, inaccurate, damaged, incomplete, non-delivered, or sent by postage-due mail. The failure of the Northgate to comply with any provision of these Official Rules due to an act of God, hurricane, war, fire, riot, earthquake, terrorism, act of public enemies, actions of governmental authorities outside of the control of Northgate (excepting compliance with applicable codes and regulations), or other force majeure event will not be considered a breach of these Official Rules. Promotion Parties assume no responsibility for any injury or damage to any Entrant s or to any other person s computer relating to or resulting from entering or downloading materials or software in connection with the Sweepstakes. Promotion Parties are also not responsible for printing, distribution, or production errors or for technical, hardware, communication system, software, or telephone malfunctions of any kind related to the Sweepstakes. If Northgate determines, in its sole and absolute discretion, there is any suspected or actual attempt to deliberately damage the Sweepstakes or the operation thereof, any tampering with any portion of the Sweepstakes or compromise of the integrity of the Sweepstakes, Northgate reserves the right to take all actions it deems appropriate, in its sole and absolute discretion, including voiding suspect Entries, modifying or terminating the Sweepstakes, and conducting a random drawing to award a Prize Package using only those Entries Northgate deems to be nonsuspect. Without limiting the generality of Northgate s authority regarding the conduct of Sweepstakes, Northgate reserves the right to disqualify any person who tampers with the Sweepstakes or violates the Official Rules. The Sweepstakes is void where prohibited. All federal, state, and local laws apply to the Sweepstakes. Decisions regarding all matters relating to the Sweepstakes that are not addressed in these Official Rules, including the validity of any Entry, shall be made by Northgate in its sole and absolute discretion, and each Entrant agrees that all such decisions shall be binding and final. Failure to comply with these Official Rules may result in disqualification from the Sweepstakes at Northgate s sole and absolute discretion. Northgate reserves the right to permanently disqualify from any promotion any person they believe has intentionally violated these Official Rules. Questions regarding the Sweepstakes should be directed to: Northgate Gonzalez, LLC, Attn: Northgate Customer Service Center, 1201 N. Magnolia Avenue, Anaheim, California 92801. All issues and questions concerning the construction, validity, interpretation and enforceability of these Official Rules, or the right and obligations of any participant and/or Entrant, will be governed by, and construed in accordance with, the laws of the State of California, without giving effect to
any choice of law or conflict of law rules or provision that would cause the application of the laws of any jurisdiction other than California.