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Date: <br />Event Name: <br />Organization: A <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: <br />Email: _��� i <br />Address: 2YZI, " _' <br />Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Event Date: <br />1 . <br />Zl <br />Alt Phone: 2-7) _ /711 7 <br />City/State/ZIP: <br />Event Location (Please describe): <br />2 / Lir �/1&W <br />Length of Event (Dates/Times): <br />4 <br />1fW---- 7, <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 suffe, <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 />Authorized Organizer <br />