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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: LA Event Date: 5 ' -lxO - 2\ --___—__ <br />Event Name:r m,s-X C o iIC n .a, <br />Organization: <br />Applicant (Contact) Name: C4 e-1.: d <br />Applicant(Contact)Phone:!-t'1-(1015 tlN\1 _Alt. Phone: ----------- <br />Email: -(-'-ur <br />__—__—_--_Email:_Cut 1 : nn C�1�1S� CAGSc�a •� op -- --------_—__-- <br />Address: _1�_a,jrQnl��ri7_\e� Sb City/State/ZIP::_1�___—yl.y____ <br />Event Location (Please describe): <br />Length of Event (Dates/Times): S -3 <1 60J r!\ O b fl ro\ — <br />APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any <br />liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer <br />or incur as a result of any claims or actions which may be made against the City, its agents, employees, or <br />subdivisions by any person, including a participant in the activity, arising out of the approval of this request by <br />the Civil City of South Bend, Indiana, through the Board of Public Works, to close a portion of the public right-of- <br />way for the event described above, or for any harm or damage alleged to have occurred because of the holding <br />of the special event. The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: N- 'JL-- I —______ <br />Organizer Signature <br />4------=-Q.D-n�—'------------------- <br />Printed Name and Title <br />