Laserfiche WebLink
Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: /J y` 2 Z 3 Event Date: 7- 51- ;Z,3 <br />Event Name: 4 op-/I <br />L-/,09 e, tit 0 % <br />Organization: /I O/) ei <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: .�/�� Alt. Phone: <br />Email: 70eSP�lj /%�Li_Sl 3f � 0, M4//- COI4h <br />Address: /'f �2 Z6//z/// Cl1City/State/ZIP: <br />Event Location (Please describe): <br />Length of Event (Dates/Times): 69 <br />r- / - a ? /17/e <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: 7 ^ (� 9 _ S <br />Organizer Signature <br />Printed Name and Title <br />0 <br />