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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: <br />2 <br />Event Date: <br />4 - Z 7 <br />Event Name: <br />l30Z5 <br />4 C�� <br />Organization: <br />Applicant (Contact) Name: <br />Applicant (Contact) Phoney 2 Yo foe - 0/ 4 D Alt. Phone: <br />Email: <br />C1 WNN'ZA <br />Address: <br />S 0 4- t /c <br />S <br />City/State/ZIP: <br />Event Location (Please describe): <br />2n� e �Grlt <br />Length of Event (Dates/Times): <br />T0-1/1PGYL / <br />Pn enrr Off" 'ice �(.,, <br />W e Ore <br />5 <br />PeSe�v,�� -rGt <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 maybe 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: /Z/ Z -1 <br />Authorized Organizer Signature <br />t1✓��O �'✓YF Jl /`("�'C5 (/��LGf+�r Ya'' 9','5 t &/"/, G/O. <br />Printed Name and Title <br />0 <br />