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Section E - Indemnity & Hold Harmless Agreement <br />OWN <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: W21411i Event Date: 6 /6 Iz 5-- <br />Event Name: '5+• Te5<,ok brmd4, 5r-hoo1 f�--t [Jt C%u <br />Organization: c.4 • SOScob. G-m&g 5c koo ( <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: U7 Y) Z 2 O —2 3 25^ Alt. Phone: <br />Email: <br />k6lvin4,VIrlq <br />30n%&�I. (am <br />Address: <br />2I6 <br />N. <br />(+W S�. City/State/ZIP: S&W1 6,e*,d, �PN Y64 ( 7 <br />Event Location (Please describe): <br />Evzrr� t�1[es �JlaLe moll-Iy t� s�hoc) Ca.hP�S and PRSGhoo� Ca �S <br />w iji- 6. ac t irrs at closed s by-M+ d s�Fi �a s sry� hr ch I Gl� cn. <br />Length of Event (Dates/Times): 616, 9 am — 3 pm� <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: if/Z K 12 s— <br />� /Si <br />Authorized Organizer Signature <br />1-17-t%elA ^ c4,y — iaw Oav a4-'r <br />Printed Name and Title <br />E <br />