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Section K - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Dater a Event Date: J I I % / gaS <br />Event Name: -MARCH (OR ) if-E -' SouT}i 9emb <br />Organization: ( D (AFE mLk C <br />Applicant (Contact) Name: R 1 FF I N M C%[ A(f 1F-: <br />Applicant (Contact) Phone: % 232 S 33 Alt. Phone: 317 ' s; q - qiL4 <br />Email:.1JU TREs4040 MQ 1F-GA0 H(A fA 0RG <br />Address: `RC)Q 1 (((CiN WQQ0 CIR, City/State/ZIP: 5QJTK VIENR 1AJ q6KR.V <br />Event Location (Please describe): <br />Length of Event (Dates/Times): V u I a S 11, yA I/ f% f_ a s 1 a PM <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: Rl "T TO LtFE M tCH (ANC INC . 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: <br />Authorized Organizer Signature <br />GR V-P9 N W44 A PF ( <br />40 Printed Name and Title <br />