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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: / Event Date: l�Ll/IC // /� aod3 <br />Organization: 4-C7vt/5-- <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: Alt. Phone: _ V /-G�GI—Jr�// �L✓%�C, <br />Email: ��4�41�iiu2�.ic /53 4.✓J41� GUM <br />Address: /mow S.3/� Y City/State/ZIP: .ScY.ffi 1T6W'0 �• yG6✓J <br />Event Location (Please describe): <br />Length of Event (Dates/Times): dl7' coo li -2 iV <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 attorneyfees, 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: a3 <br />Authorized Organizer Signature <br />Printed Name and Title <br />C� <br />