Laserfiche WebLink
• <br />Date: August 1, 2023 <br />Event Name: Block Party <br />Section E - Indemnity & Hol_d_Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Event Date: Sept. 4, 2023 <br />Organization: <br />Applicant M. Lewis <br />(Contact) Name: _ <br />Applicant (Contact) Phone: (574) 276-0726 <br />Alt. Phone: (574) 274-3520 <br />Email: jaygreta@gmail.com <br />Address: 633 N. Coquillard Dr. _ City/state/ZIP: South Bend, IN 46617 <br />Event Location (Please describe): <br />Labor Day Block Party on N. Coquillard between Rockne and Cherry Tree <br />Length of Event (DatesTrimes): 9/4/2023 from <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 stiffer <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 terns. <br />Signed on this Date:` <br />A <br />Signature <br />iM -� ' <br />Printed Name and Title <br />11 <br />M <br />