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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: I - aarl - as 5 Event Date: 5 - 31 - A 5 <br />Event Name: Sunbut"I Races <br />Organization: Beacon NeQK11 SVsAM <br />Applicant(Contact)Nam . UU11_n1eU KIVKU 11m15 MCI <br />Applicant (Contact) Phone `J I y - 51 ti - y � 11 Lp Alt. Phone: <br />Email: CVue((# heawnhea_\)r syskin ma ; ilUyls(m MyMeg enh.co <br />Address: 3�I i)e.QC00 MYWa�j —City/State/ZIP: M\Ch i wak. N !4�530 <br />Event Location (Please describe): <br />Races CA0A and kini5h ak -Nne Cervaq Op-r4f, see ifC*QAi \Je aoa5 <br />wuxw Mq5 Hof ewrA- fou�es. <br />Length of Event(Dates/Times): 5-31-a5 TODW 'tlN 1`\1ne_ UpseS t' IV.WN <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: Beacon A1ea1;h S\Is�em 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: � -ai - a 5 <br />Authorized Organizer Signature <br />Races D 1f <br />• Printed Name and Title <br />