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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />• <br />0 <br />Date: 2 Z Event Date: 7 /Z I / 23 <br />EventName:E• Wash1h71T Nct'ghbo�-hood'6IockP4 <br />Organization: <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: <br />Email: I {/r L I L4-V1 a. <br />rti <br />wiau ch-@hotmai'L. cv <br />U A <br />Address: I(%3 N - Imil UN*b AW - City/State/Z I P: k�P kj y�hd, �Dl� 4W I <br />Event Location (Please describe): <br />-E. Vila&kij-bh A-ect k+Nran Taeoh and S��vu�Side <br />Phone: S]4' 3 t7 I ' 8C✓cp-7 <br />Length of Event (Dates/Times): <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: 5 ZC32 3 <br />Organizer Signature <br />?,Vl I Ct, Co <br />Printed Name and Title <br />