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• <br />Date: U o1c <br />Event Name: <br />Organization: /)t <br />Applicant (Contact) <br />Applicant (Contact) <br />Email: —"Pi <br />Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Event Date: d �a <br />C"C -e— <br />> M IZ Q' C <br />C/o 6-31V4 <br />!7 <br />Address: //"G3 7 ho Y l ctS I City/State/ZIP: <br />Event Location (Please describe): <br />Length of Event (Dates/Times): 5 <br />I,�T-031 <br />• APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any <br />liability, loss, costs, damages orexpenses, 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: <br />Authorized Organizer Signature <br />Printed Name and Title <br />