Special Event - March to Memorial - September 11

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DocuSign Envelope ID: 66460207-F681-4F9A-BC29-F7BB7DOF1A3B Section K - Indemnity & Hold Harmless Agreement City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Date: 02/08/2021 Event Date: 09/11/2021 Event Name: March to the Memorial Organization: March to the Memorial Inc. Applicant (Contact) Name: Bob Lyons ._- Applicant (Contact) Phone: 314-452-5717 Email: bobplyons@yahoo.com Address: 52160 Woodsedge Dr. Event Location (Please describe): 9/11/21 from 9:1 lam to 6:45pm Length of Event (Dates/Times): Alt. Phone: City/State/ZIP: Granger IN 46530 Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate, and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board of Public Works as additionally insured for the event. Organization Name: March to the Memorial Inc ---------- agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, Indiana, may suffer or incur as a result of any claims or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana, through the Board of Public Works, to close a portion of the public right-of-way for the event described above, or for any harm or damage alleged to have occurred because of the holding of the special event. The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. Signed on this Date: 02/08/2021 DocuS;--�; by: 664 t S957162B4E9 Authorized Organizer Signature Bob Lyons, Founder ---------------- Printed Name and Title