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Section E - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: -5 I S 12S Event Date: ppb/ % F z- S <br />Event Name: ^ 'V`Cy <br />Organization: <br />Applicant (Contact) Name: TE u u I c <br />Applicant (Contact) Phone: 514 Alt. Phone: <br />Email: 1 MC- 1L' e- <br />Address:S311 LA -V-siPwA DILLv�L City/State/ZIP: GV'r-i &rP40 I rj L441'i_ <br />Event Location (Please describe): (201JM FLT NG STIti.`F� gT -rL'ZZ"j (^'% �IGf•( <br />1�"'�9�-T(� �/1'V% I n1 O�-•,IZ. Sln LSD) V 151.Y.1 <br />Length of Event (Dates/Times): C�' / ZS "' _ �pn <br />• APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any <br />liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer <br />or incur as a result of any claims or actions which may be made against the City, its agents, employees, or <br />subdivisions by any person, including a participant in the activity, arising out of the approval of this request by <br />the Civil City of South Bend, Indiana, through the Board of Public Works, to close a portion of the public right-of- <br />way for the event described above, or for any harm or damage alleged to have occurred because of the holding <br />of the special event. The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: <br />A <br />Authorized Organizkk Signature <br />-3e?.jK)Iyj�— "C- I>t� iXPs.�is�c2 i ZhJ4-AC'V't/Fr ryL GX'r, D)nZcT•zo,� <br />Printed Name and Title INN 9 �~ ('.> . %) s c.. <br />0 <br />