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Section K - Indemnity & Hold Harmless Agreement <br />• <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: 3�12�2y Event Date: V)s/';Lti <br />Event Name: <br />Organization: >AL-VA'riotO AeNY KSZvc-Fti>Tc(Z <br />Applicant (Contact) Name: e5h�#%KAWyAtJ X; C r L E <br />Applicant (Contact) Phone:Alt. Phone: D!$ 1 <br />Email: SArti.k. VCf;ckh a Vie Sal✓A+ arm o/a <br />Address:—qDii W. Wt=STr2N AVF- City/State/ZIP: vTN FCiO T6601 <br />Event Location (Please describe): <br />traC cC✓4ce . z2 cx /o✓4-2 <br />iV r S We +-a `%Lio-_ �j D �C.� � ✓ Se. <br />Length of Event (Dates/Times): t; IS�2y ' 30 A04 , J ) t Ov AM <br />• Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate, <br />and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board <br />of Public Works as additionally insured for the event, <br />Organization Name:.S ,.yA-rioN Arem4 UeOC 6E:NTEi2 agrees to indemnify, defend <br />and hold harmless the Civil City of South Bend, Indiana, from any liability, loss, costs, damages or expenses, <br />including attorney fees, which the Civil City of South Bend, Indiana, may suffer or incur as a result of any claims <br />or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a <br />participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana, <br />through the Board of Public Works, to close a portion of the public right-of-way for the event described above, <br />or for any harm or damage alleged to have occurred because of the holding of the special event. The <br />undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: 3 / 2 Lf <br />Authorized Organizer Signature <br />�SAaA�11 VAfQ, tCkLE t +IEALTLI L �ASS MANA-CK: <br />• Printed Name and Title <br />