Laserfiche WebLink
Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: `' / � 7 I Z%22 Event Date: �3 0�0---? z1 <br />Event Name:��S��XY7"Yl'I�D <br />Organization: Z,— <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone <br />Email: <br />Q�%��� Ci <br />Address: <br />Alt. Phone: <br />City/State/ZIP: <br />Event Location (Please describe): / 5;- <br />00*4 <br />71 <br />e5 <br />Length of Event (Dates/Times): <br />%7q <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: pZ o2'* 'z-7 <br />)rizep Org r& er Signature `Vav-a D/-PSI ) �/sGcJD�.4/oel� A <br />Printed Name and Title <br />1J <br />/m/vt662.. <br />