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12/08/2016 16:36 5742333125 XRC BILLING PAGE 03/07 <br />1 • Sponsor shall reimburse the Board <br />necessary. <br />2. Sponsor shall provide to the Board <br />f411 force and effect with limits <br />aggregate and the City of South Be <br />3. Sponsor shall provide to the Boar <br />required for the event. <br />A, PROCESSION <br />the actual cost to the City for the event, if deemed <br />t Certificate of Insurance showing a liability policy in <br />of $300,000.00 per occurrence and $5,000,000.00 <br />d listed as an additional named insured for this event. <br />all additional licenses, permits and documentation <br />4. Sponsor agrees to abide by all terms and conditions of the Board's policy governing <br />walks, runs, parades or other similar event adopted by the Board on March 3, 1995. <br />5. In order to ensure public safety firing the event, the Board agrees to furnish traffic <br />planning, materials, equipment and personnel as deemed necessary by the Police <br />Department Traffic Bureau, the Bureau of Traffic and Lighting, and, where <br />the Board of Park CormnissioneTs. applicable, <br />6. Sponsor acknowledges that the PoliL Department reserves the right to chang this route <br />for safety purposes. �( <br />7. In consideration for approval by th, <br />set out above, the undersigned ag1 <br />Bend, Indiana, free and harmless <br />expenses, including attorney fees, <br />incur, as a result of any claims or a< <br />Participant in said activity, arising c <br />I <br />ndicated in the City of South Bend. <br />bind the above mentioned sponsor tc <br />8. .Notification of approvatIdenial of thl <br />signed authorization by the ,board of� <br />I understand the above rules and regulations) <br />any false or incomplete information. <br />Sponsor Signature <br />Printed Nacre <br />Title Executive <br />Member <br />Board and the use of the sidewalks for <br />ees and undertakes to hold the Civil C: <br />from any liability loss, costs, costs, <br />which the Civil City of South Bend m� <br />tions which may be made by any person, <br />It of the approval of the request to use th <br />The undersigned certifies that he/she is a <br />the terms hereof. <br />s request will be issued by return of this <br />ublic Works <br />and that this application may be denied b <br />AL <br />L <br />u ET: RN FORM TO: <br />Board of Public Works <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />Sout}l Bend, IN 46601 <br />Phone: (574) 235.9251 0 Fax: (574) 235-9171 0 B-Mail: publicwks@southbendin.gov <br />purposes <br />of South <br />wages or <br />suffer or <br />icluding a <br />sidewalks <br />horized to <br />rrm, upon <br />:d on <br />