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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: August 9, 2021-- Event Date: Sept. 6, 2021 <br />Event Name: Block Party <br />Organization: <br />Applicant (Contact) Name: James -M. Lewis <br />---------- <br />Applicant (Contact) Phone: (574) 276-0726....... 274-3520 <br />_ _______ Alt. Phone: <br />Email: laygreta@gmail.com <br />--------------------------------- <br />--------------------------- - <br />633 N. Co uillard Dr. South Bend, IN 46617 <br />Address: _ _ 4 _— City/State/ZIP: <br />Event Location (Please describe): <br />Labor Day Block Parry on N. Coquillard between Rockne and Cherry Tree <br />Length of Event (Dates/Times): 96/2021 from 4-6pm <br />APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Send, 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 Djte: ��l — <br />Printed Name and Title <br />