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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:�1121 Event Date: x/3(/2► ___ <br />Event Name: <br />Organization: <br />Applicant (Co <br />i <br />ntact) Name—,Z4 <br />Applicant (Contact) Phone: S? A _ 4 766 4 --_----- Alt. Phone: qO3 — a4_ l 0 <br />Address: _moi $ • ` ,� City/State/ZIP: <br />Event Location (Please describe): <br />'*Jc'c,w A A� <br />Length of Event (Dates/Times): _ s qL♦ u=1�, D �� (04� <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:( <br />Signature <br />Printed Name and Title <br />