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Special Event - Madison Street 4th. of July Party-July 4
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Special Event - Madison Street 4th. of July Party-July 4
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6/22/2021 3:26:12 PM
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6/22/2021 3:26:02 PM
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Board of Public Works
Document Type
Recommendations
Document Date
6/22/2021
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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: _�_� ��Event Date: -7- Ll -- <br />Event <br />_L - <br />Event Name: /A��Spy� S} _ !}h <br />Organization: -__ ............ <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: (5t-7)50 5 - S'Z (o"'2- Alt. Phone: <br />Email: �QUL,(e S9.�L�C-------------------- ---- --- ----------- ---------- - <br />Address: _ E M .gyp �City/State/ZIP: _�0.��_ i�ZN 1�.. L.0(o ( <br />Event Location (Please describe): <br />0t,kA600cs, Mad;so r., S}reed . <br />Length of Event (Dates/Times): <br />C <br />1'L'.0O rM <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: -L-I- G L__ <br />Authorized Orgarpzer Signature <br />Printed Name and Title <br />
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