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Y •1 1�_-n� � ._,...: a .. .- - <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: u� D� o20,2 %� EvenAt%ate: emu- c/ 6W 3 <br />Event Name: t�dl/r �/f1fi8D <br />Organization: k'S <br />Applicant (C/oon�tact)QPho�ne:.5-'/ 4 / -/✓ I? U Alt. Phone: <br />Email: <br />Address: <br />City/State/ZIP: <br />Event Location (Please describe): -IX-4 <br />leUS- � �% C 0�r5 cNe� / j%/ 44e,7 <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 />_.-__..IL [ _I _L' .1 '_L ..L -J '.__L LI _!-L 'L L ._1 . <br />VI IIM1MI PiOI..iYII V1 Pllr V,P 11'.J V. P..LIVI IJ.VIPVI•... IY..IIIPY..Q(jP..... .... VILY, 14i Orjl.l•N,..I,IIJ\V VI.Jf VI <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: <br />Authcrlznd <br />Printed Name and Title <br />C� <br />