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PERMIT AGRRIJMI♦ NT FOR. A. PROCESSION 1. Sponsor shall reimburse the Board for tine actual cost to the City for the event, if deemed necessary. 2. Sponsor shall provide to the Board a Cer tr01cate of insurance showing a liability policy in full force and effect with limits o.f $300,000.00 per oecutTonce and $5,000,000.00 aggregate and the City of South Bend listed as an additional named insured for this event. 3. Sponsor shall provide to the. Board all additional;licenses, pcznn is .and documentation required for the event. 4. If this event results in closure of a residential street, all residents within the aMcted area :-'lllLlO4.':VV...31V •11Av.N '.:vi.:: ,.uau...v.. vex . t �>.... �.�..;.. i..� .�...� .....«.-. ,. _.___., __ _..____ ..,._. _.3... ilptiti all residents that reside on the block.' A copy of a brochure or letter desrribilxg .the event purpose, date, and trine inust be distributed to all affected neighbors and included.with the application. 5. If this event results in closure of a residential street, the applicant is responsible, prior to the event, for determining if there are any residents affected that could potentially need assistance in accessing their residence. The..applicant is :re sponsi<ble £or providing said resident access. or Vansportation to their property, 6. Sponsor. agrees to abide by allterms and conditions -of.: theBoard's policy. governing .Walks, runs, parades of other similar event adopted by the Board on March 3,19.85. 7. In order to ensure public safety during the event, the Board agrees to furnish traffic planning, materials, equipment and personnel as deemed necessary by the Police Department TiaMc Bureau, the Bureau of Traffic and Lighting, and, where applicable, the. Board of Park C- - ' . 'signers, . . . . . . . . . . . . . . . . .. ... . . . . .. . . . . B. Sponsor acknowledges that the Police Department reserves the right to change this route for safety purposes. 9. In consideration for approval by the Board and the use of the sidewalks for the purposes set out above, the undersigned agrees and undertakes to hold the Civil City of South Bend, Indiana, flee and harmless from any liability loss, costs, costs, damages or expenses, including attorney fees, which the Civil City of South Bend may suffer or incur, as a result of any claims or actions which may be made by any person, including a participant in said activity, arising out of the approval of the request to use the sidewalks indicated in the City of South Bend. The undersigned certifies that -he/she is authorized to bind the above mentioned sponsor to the terms hereof. 10. Notification of approval/denial of this request will be issued by return of this form, upon signed authorization by the Board of Public Works l understand the above rules and regulations and that this application, may be denied based on any false or incomplete information. Sponsor Signature14 RE TURN rARM TO: Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, M 46601 Phone: (574) 235-925 r ® Fax: (574) 235-9171