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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: Event Date: ro 110'Z <br />/ <br />Event Name: I Y r/'KIA LA !: -Vi['N 0- 0 4-4, 1 /R Iry - <br />Organization: <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: (y- L4 6 & I Alt. Phone: <br />Email: Yfl n <br />Address: l l33 City/State2lP: 3�I'�L K.P,�e <br />Event Location (Ppleasedescribe): + bt-I l d OCDu� howta CCD <br />l ( 33 C, &—<; ec( <br />Length of Event (Dates/Times): Rf 1 t <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: 51` ( e—� <br />Authorized Organizer Signature <br />Printed Name and Title <br />0 <br />