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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: I Z -1 ti - ZO Z Z- <br />Event Name: {MAC—hn LUA <br />Organization: t 't 0 cV lAj <br />Applicant(Contact)Name: W <br />Applicant (Contact) Phone: <br />Email: �1U�1.15Gk��UC�G <br />Address:2'T / S K et< 5- <br />Event Location (Please describe): <br />Length of Event (Dates/Times): <br />Event Date: I (P — Z0 3 <br />-«g .fix. 'e rf-bita <br />i' i+l tit ll6wmux,V+ <br />I-/&-7023 <br />4-r ova rr lqK c ll <br />Phone: <br />e <br />City/State/ZIP: SOfA /yGNd IOU 11� (Iriz <br />APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any <br />liability, loss, costs, damages orexpenses, including attorney fees, which the Civil City of South Bend, maysuffer <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: /,? - 11 -Z4%ZZ <br />Authorized Organizer Signature <br />r� <br />Printed Name and Title <br />