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Section E - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />qq Indemnity & Hold Harmless Agreement <br />Date: 7 jd� Event Date: ' 15 /9J, <br />Event Name: <br />Organization: <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: !US . d l / - i z530 Alt. Phone: <br />Email /`iIm -f�y "5 <br />Address: c3r9l M�pbierS,�Y1 City/State/ZIP: Yf &I?CI_lA,( q(/G��1 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): V/�/O� l <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: 3 <br />Authorized <br />Printed Name and <br />40 <br />