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public liability insurance, with coverage not less than $300,000 per person and <br />$1.000.000 per occurrence, naming the City as an additional Insured as to the sidewalk <br />cafd operations. Permittee shall provide a Certificate of Insurance to the City showing <br />liability coverage as required above and providing for not less than 30 days' notice to the <br />City's Board of Public works prior to cancellation. <br />14) Should Permittee fail to comply with any of the terms or conditions of this Agrecrrcnt. <br />the City, by its Board of Public Works, may revoke the permit to utilize the public <br />sidewalks as granted herein. <br />15) The rights granted herein may not be assigned by Permittee. <br />16) Notification of approval/denial of this request will be issued by return of this form, upon <br />signed authorization by the Board of Public Works. Please provide a contact email. <br />IN WITNESS WHEREOF, <br />above. / <br />Permittee Signature <br />Name: <br />Title: <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />was executed on the date first written <br />Date: S f - % ,� <br />�V' <br />Joseph R. Molnar, Vice President <br />Jordan V. Gathers, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: May 23, 2023 <br />