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• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: 01/04/2025 <br />Event Date: 05/03/2025 <br />Event Name: Cinco de Mayo Festival <br />Organization: St. Adalbert Parish <br />Applicant (Contact) Name: Fr. Ryan Pietrocarlo, CSC <br />Applicant (Contact) Phone: 574- 288-5708 Alt. Phone: 574- 334-0049 <br />Email: rietrocarlo@stadalbertschool.org <br />Address: 2505 W Grace St City/State/ZIP: South Bend, IN 46619 <br />Event Location (Please describe): <br />Length of Event (Dates/Times): 05/03/2025 from 12:00 - 8:OOpm <br />Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate, <br />isand 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: St. Adalbert Parish 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: I N /a s <br />M <br />Signature <br />Fr. Ryan Pietrocarlo, CSC, Pastor <br />0 Printed Name and Title <br />