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Section K - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date:T",.., s-4�loi-4 Event Date: ir'-u 2.LEI2.02-Lf <br />Event Name: -6 C-jK ?ehre -Qt�%,tCyvn�w+�V.ar/-arA'VY--' <br />Organization: l', u,� P Jk&iE C-L. , wr L-t <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: Alt. Phone: C11601) a T2- - tfZ( <br />Email: PtLO\'-0AA G tt A.)-_4 Address: l$D'bS City/State/ZIP: C JG>tiJ:L% <br />Event Location (Please describe): <br />Length of Event (Dates/Times): Y-2— V-, c, /1 �kG �-2, L', 202-4 �q <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 />O k ', V L'V N N E (_ V�%ti V'C k 1 I al iV tli'✓e i�>r-i. %,-- < <br />Organization Name: A"J-*- !n kt-t% 11 a6 MLc;A 'KQ t 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: Tw �\ K —VC% o AA - Jr' Ca "`s 1..4/:-�� Cf <br />Authorized Organizer Signature <br />• Printed Name and Title <br />