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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: O ��Z °� Event Date: <br />Event Name: Z46cfr 6?r' <br />q � , . S' -'�/7� <br />Organization: C//Ml —t Cgs 1"Pct' ayy- N.. �f E <br />Applicant (Contact) Name: nsnJ a u5, , v.. <br />Applicant (Contact) Phone: J?Y- $4 a72 % Alt. Phone: ` <br />Email: �'fa0.Qy Ro(- r✓L- <br />Address: 20)•P,K Lri6City/State/ZIP: <br />Event Location (Please describe): <br />Length of Event (Dates/Times): y /O: r/a t In Z 6 7--cs 3 `:" P--'t`- <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: c 1Ct?4 <br />Authorized Organizer Signature <br />Z. <br />Printed Name and Title <br />11 <br />t <br />