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Section K - Indemnity & Hold Harmless Aereement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: S 108 120-24 Event Date: U 12q 12 0214 <br />Event Name: EOLS-t 7.c.c-n- WQ-f- ylU&W LAU", CIRAR�py k*i by-1 <br />Organization:O�:%kS4. � O{ hUAV%YlrA UPnup\ )aXILS £ pcy-k-5 <br />Applicant (Contact) Name: \ Y BRA.. \A4n n0_ <br />Applicant (Contact) Phone: Alt. Phone: 2V1- Yy 0 -13yZ <br />Email: )OA"Qylyla Cs �lll}k1yhPJ1C�tYf ACfJ <br />Address: Dlot 'o - '54- Ua \S `U • City/State/ZIP: ill)l}�� 02Y1a� (N , �IQlD�1 <br />Event Location (Please describe): <br />East ►"�auz W 0a-U wa►-t 109 S. NJ' L " AU SQ�►�n �cr\d ,1N `�� � 1-1 <br />'btyLLk Sovw-% Us Ave b we9rA E W"rAtylc�tbrn a and E. <br />tE <br />Lengt of Event (Dates/Times): JU11P 201 202ti AM - B pnA <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:y cnu CS p0"-V . E Ay+-7" 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: S 1ID (6 I -) _t l <br />Authorized Organizer <br />McLuI4 NDv�ntii 1J'l��CtDY of 1�ecr�ofiJ�l Exper��ruQS <br />0 <br />Printed Name and Title <br />