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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless <br />�Agreement <br />Date: =_I_�_ I ___—_—_ Event Date: —_—[_� _�__= <br />Event Name: <br />r <br />Organization: -- �S2r1�------ -------- <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: $7��j��_��i --------- —_ Alt. Phone: SfLY_31,2Q--aRS-g___ <br />Address: _Q2_—�3Q (i ------ City/State/ZIP: • _%/JL_���j�� <br />Event Location (Please describe): T <br />LA0-, P,. � ru-Q- <br />Y - <br />Length of Event (Dates/Times): _*,.q____^—� <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: -6 - ---------- <br />Authorized Organizer Signature <br />1, 1I LLGV I NCI 11p 01 I V IIOO <br />