Laserfiche WebLink
PERMI'T/AGRICRMENT <br />FOR A PROCESSION <br />I . Sponsor shall reimburse the Board for the actual cost to the City for the event, if deemed <br />necessary. <br />2. Sponsor shall provide to the Board a Certificate of Insurance showing a liability policy in <br />full force and effect with limits of $300,000.00 per occurrence attd $5,000,000.00 <br />aggregate and the City of South Bend listed as an additional named insured for this event. <br />3. Sponsor shall provide to the Board all additional licenses, permits and documentation <br />required for the event. <br />4. Sponsor agrees to abide by all terms and conditions of the Board's policy governuig walks, <br />runs, parades or other similar event adopted by the Board on March 3, 1985. <br />5. In order to ensure public safety during 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 applicable, the <br />Board of Park Commissioners. <br />6. Sponsor acknowledges that the Police Department reserves the right to change this route <br />for safety purposes. <br />7. In consideration for approval by the Board and the use of the sidewalks for the purposes <br />set out above, the undersigned agrees and undertakes to hold the Civil City of South Bend, <br />Indiana, free and harmless from any liability loss, costs, costs, damages or expenses, <br />including attorney fees, which the Civil City of South Bend may suffer or incur, as a result <br />of any claims or actions which may be made by any person, including a participant in said <br />activity, arising out of the approval of the request to use the sidewalks indicated in the City <br />of South Bend. The undersigned certifies that lie/she is authorized to bind the above <br />mentioned sponsor to the terns hereof, <br />8. Notificatiort of approval/decrial of this request will be issued by return of Phis forth, rrpott signed <br />authorization by the Board of Public Works <br />I understand the above rules and regulations and that this application may be denied based on <br />any false or incomplete infomzaf t . 1 <br />Sponsor Signature /L <br />Printed Name info? <br />r Jank <br />Title President— Bike Michiana Coalition <br />B A OF PUB .IC WORI S APPROVAL <br />✓t ✓� <br />President Member Member <br />Member Member Date <br />RETURN FORM TO: <br />Board of Public Works <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />South Bend, IN 46601 <br />Mimic: (574) 235-9251 a 1'ax: (574) 235-9171 a P.-Man: publicwl<s(n�soutbbcndin.gov <br />