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application only. Event end times are pursuant to the recommendations ofthe South Bend Police <br />Department. <br />13. IF ALCOHOL IS TO BE SERVE D OR SOLD a Certified Check or Money Order for $400.00 <br />must be submitted with application. The application cannot be processed without a deposit. Tile <br />deposit will be returned by the Board of Public Works upon inspection of the event area after the <br />event, and provided there is no damage to the area. Names, phone numbers, and qualifications <br />(e.g. Off -duty police officer, professional security guard, or event APPLICANT) of TI-IREE <br />security guards to monitor underage drinking, must be submitted with the application, A drawing <br />must be submitted showing fencing around serving area, and trash receptacles. For a temporary <br />liquor license call the Alcohol and Tobacco Corrunission at (317) 234-4315 for more <br />information. Application cannot be processed without a copy of this license, <br />14. APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, <br />Indiana, from any liability, loss, costs, damages or expenses,, including attorney fees, which the <br />Civil City of South Bend, may suffer or incur as a result of any claims or actions which may be <br />made by any person, including a participant in the activity, arising out of the approval of this <br />request by the Board of Public Works to close a portion of the public right-of-way for the event <br />described above, <br />I have read the Application and. Permit and the Agreement for the "Use of Right -of -Way for Special <br />Events" and I understand and agree to the above rules and regulations. I also understand that this <br />application may be denied based on any false or incomplete information. <br />Dated this / a .. .. ....... . ... . . ... . day of I " <br />APPLICANT Signature <br />/n <br />Printed Name <br />BOARDjOF PJULIC WORKS APPROVAL <br />Ilk <br />President Mem er Me ber <br />Member Member <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 />Phone: (574) 235-9251 <br />L <br />Date <br />