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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: O5 a Event Dilate: O p ?J <br />Event Name: 0,F] (Y)u_v)/-iv R"L <br />Organization: I r I (J. P t LAy me-L/ r It SS I U✓1OYI Cam` 9 lV- .CJ2Ll -'U, <br />Applicant (Contact) Name: l .1 & ffi <br />Applicant (Contact) Phone: 5-7q 53oa I Alt. Phone: c�- IQ 7 I6 --32 3W <br />Email: cki� -1 46,A I J P ) aAL.1m>-, <br />Address: <br />City/State/ZIP: <br />Event Location (Please describe): <br />Ckj4Yt.:' — cOVt VxulV1q <br />Length of Event (Dates/Times): A -LA) L& V 5� 10 4n 'V 3p I , <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: 2 <br />Authorized Organizer Signature <br />Printed Name and Title <br />0 <br />- fve'mt-co-lcm4 - <br />