Laserfiche WebLink
Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />14- <br />Date: (Y) � ,?•�,t..,t'�p� Event Date: f7tJ � —2 0 3 <br />Event Name: E3! ` �1 A-C-1 )94-i-4V <br />Organization: <br />Applicant (Contact) Name: <br />Applicant(Contact)Phone: %y—�2 �Z— /095 Alt. Phone: 57Y2�00- F�g <br />Address: ��� Z%- I IX� I/ �1P City/State/ZIP: }�A ,-To '1 13 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): F ydn- O(U -< <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 APPLICANTto these terms. <br />Signed on this Date: )q(J 0- 90 c�0,�)- 3 <br />Authorized Organizer Signature <br />Printed Name and Title <br />9 <br />