Laserfiche WebLink
• Section E - Indemnity & Hold Harmless Aereement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: O:q 0 9/ as a 3 Event Date: 0 4 j 08 / B .Q'k3 <br />Event Name <br />Organization: �1(T ''Q1sy�.-`.''`y�S� �3 0V—O NOOI Couvl l <br />Applicant (Contact) Name: ia':6A� \. W �� —1 J <br />Applicant (Contact) Phone: 5 % — Z (U —O h Lj.$' Alt. Phone: 5 / t4—.5O —� I Wtb'j•}th) <br />Address: <br />City/State/ZIP: 5R/j PI 14 6 6_:1 <br />Event Location (Please describe): <br />K6QLV-k' -i v +10 u g r s�-t <br />Length of Event (Dates/Times): O It/G !r/ A 0A 3 5. 30s„ M 8 DO p vh <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: OS (O Q / a2 O a -5 <br />Printed Name and Title <br />