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• <br />Section K - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: 10J 812 9 Event Date: I;- I N J 2 <br />Event Name: SA 1J-r )?.y N �1 <br />Organization: <ALVATwo Agm 1 e eoc <ctJrl=P- <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: <br />Email: <br />Phone: <br />Address: goo IA). wnTE2N HVE. City/State/ZIP: rr4A arAJ0. N u66U1 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): f 2 /l U 11'i g-3 a AM — 1 D ' 0'AM <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: CSALVAi-ioN Aem i rint Lcu-rEe— agrees toindemnity, 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 holdingof the special event. The <br />undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: 101812 4 <br />Authorized Organizer Signature <br />0 <br />Printed Name and Title <br />