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Section E - Indemnity & Hold Harmless Aereement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: A& d o2//-? 3 Event Date: <br />Event Name: <br />Organization: ss�� y <br />Applicant (Contact) Name: /�!/%//�� f .�x/%q /V <br />Applicant (Contact) Phone: Alt. Phone: <br />Email: J14 A-IfhlQ ov 0 &!a/Z.&M, <br />Address: ��S �jdllourdi) ccl� City/State/ZIP: 7!/Ufu o N�, - ZZ64 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): Aa )W — I p/N• <br />• APPLICANT agrees to indemnity, 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: /102 <br />Organizer Signature <br />L. <br />Printed Name and Title <br />