Special Event - Fallen Officer Scholarship Ride-August 16 2025

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Section K - Indemnity & Hold Harmless Agreement • City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Date: 03/10/2025 Event Date: 08/16/2025 Event Name: Fallen Officer Scholarship Ride Organization: Fraternal Order of Police Lodge #36 Applicant (Contact) Name: Dominick Rodriquez Applicant (Contact) Phone: 574-310-0495 Alt. Phone: Email: droddquez@southbendin.gov Address: 701 W. Sample City/State/ZIP: South Bend, IN 46601 Event Location (Please describe): &�k Length of Event (Dates/Times): One day event on 08/16/2025 from 1200-1700 Hr Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate, isand the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board of Public Works as additionally insured for the event. Organization Name: Fraternal Order of Police Lodge #36 agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, Indiana, may suffer or incur as a result of any claims or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana, through the Board of Public Works, to close a portion of the public right-of-way for the event described above, or for any harm or damage alleged to have occurred because of the holding of the special event. The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. 03/10/2025 Signed on this D te: Authorized Organizer Signature Dominick Rodriquez Event Coordinator 0 Printed Name and Title