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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />/_ �/ Indemnity & HoldH <br />armlessAgreement <br />Date: [-�- 2 0 � I ________ Event Date: V_! 2-+ ' 2- 0 21 <br />Event Name: <br />Organization:! <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone <br />Email: <br />ma <br />Alt. Phone: J7_,(___ 07 0-_- --- - ----- <br />otrhuiL. Gobi <br />UI 22A� <br />Address: l�=J_ N_ ��l nY)1�1 City/State/ZIP: D _ �ijL�_i_ �/V__' W- 1-7 <br />Event Location (Please describe): <br />Pio paYt A I 01h)ast wgch In -} h sf'etii <br />_ f -y Yv1 S U A <br />Length of Event (Dates/Times): 6_7__2-1. <br />--2 0 Z <br />2. - <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: _'-__I_' A 0 A <br />Organizer Signature <br />evl <br />Printed Name and Title <br />