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11/03/2017 FRr 17- 17 FAX <br />1000a/016 <br />PERMIT/AGREEMENT <br />FOR A PROCESSION <br />1. 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 Hoard a Certificate of Insurance showing a liability policy in <br />full force and effect with limits of $300,000.00 per occurrence and $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� If this event results in closure of a residential street, all residents within the affected area <br />must be notified of this event. The APPLICANT must make a reasonable attempt to <br />notify all residents that reside on the block. A copy of a brochure or letter describing <br />the event purpose, date, and time must be distributed to all affected neighbors and <br />included with the application. <br />5. if this event results in closure of a residential street, the applicant: is responsible, prior to <br />the event, for determining if there are any residents affected that could potentially need <br />assistance in accessing their residence. The applicant is responsible for providing said <br />resident access or transportation to their property. <br />(. 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, 1985. <br />7. 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, <br />the Board of Park Commissioners. <br />8. Sponsor acknowledges that the Police Department reserves the right to change this route <br />for safety purposes. <br />9. 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 <br />Bend, Indiana, free and harmless from any liability loss, costs, costs, damages or <br />expenses, including attorney fees, which the Civil City of South Bend may suffer or <br />incur, as a result of any claims or actions which may be made by any person, including a <br />participant in said activity, arising out of the approval of the request to use the sidewalks <br />indicated in the City of South Bend. The undersigned certifies that he/she is authorized to <br />bind the above mentioned sponsor to the terms hereof. <br />10, Notification of approval/denial of this request will be issued by return of this form, upon <br />signed 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 information,. <br />Sponsor Signature <br />RETURN R O: 3 <br />Hoard of P a W Nee <br />1316 County -City Euilding <br />227 'West 3effmon BuuIlww-d <br />South send, IN 46601 <br />phone: (574) 235-9251 o Fax: (574) 235-9171 <br />