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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />06/12/21 08/21/21 <br />Date: ________—_ Event Date: . <br />Event <br />Event Name: <br />Tim's 60th Birthday <br />Organization: <br />Applicant (Contact) Name: Leticia -Morris. <br />Applicant (Contact) Phone: 440 812 6698 <br />Email: tmtpete@hotmail.com ------------------------------------ <br />812 -Golden -Ave <br />Address:--------------------------------- <br />Alt. Phone: 440 5361238 <br />City/State/ZIP:S --Bend 46616 <br />------------------ <br />Event Location (Please describe): <br />812 Golden Ave From the adjoining alley to Riverside Dr. <br />08/21/21—from-noon till about 10:00pm <br />Length of Event (Dates/Times):—____--_. <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: 06/21/21 <br />Authorizes Organizer Signature <br />S -- <br />Printed Name and Title <br />