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• Section E - Indemnity & Hold Harmless Aereement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: <br />Event <br />Organization <br />Applicant (Contact) Name: _ ` fa I Sy nI I S <br />Applicant (Contact) Phone: _ Alt. Phone: <br />Email: /d� h S `l <br />Address: G V6 F. I��. 'j City/State/ZIP: _3C�h(�,( �� y��t� <br />Even[ Location (Please describe): <br />`rne St,rp�+ Oh -t tie S�d� o F w�kd hOUS4c, <br />Length of Event (Dates/Times): % D � y'PVV�- Ct �Yv1 <br />• APPLICANT agrees to indemnity. 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: <br />Authorized Organizer Signature <br />Printed Name and Title <br />0 <br />