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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity <br />Indemnity & Hold Harmless Agreement <br />Date: <br />Event Name: <br />Organization: _ 5 �_ L^ - <br />Event Date: <br />Applicant (Contact) Name: _ I U5151 kLL�f-1 1 \ y/VL1Cl�h�/ ----------- <br />Applicant (Contact) Phone: "1 <br />S ` �� w�U c7t� Alt. Phone: <br />Email: <br />Address:0QLQ—X- __ � ` • _____City/State/ZIP: cJO �A�'��- ) � L <br />-7 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): !�: (70 A,164 <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: -PA (I ��t7a ( <br />Authorized Organizer Signature <br />rnntea rvame ano i we <br />