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U <br />• <br />0 <br />Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Date: <br />Event <br />Organization: <br />Applicant (Contact) Name: —A. <br />Applicant (Contact) Phone:L' <br />Email: /�� �y 1 <br />Ads: CdresZ17 F f�(]li <br />Event Location (Please describe): <br />Length of Event (Dates/Times): <br />Indemnity & Hold Harmless Agreement <br />Phone: <br />City/State/ZIP: sn r t t eyi IN 4(p(�t3 <br />on tv-e side o-P �d house, <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: <br />Authorized Organizer Signature <br />Printed Name and Title <br />