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• <br />• <br />• <br />Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />+Date: �oj �'� t7 �� Event Date: <br />Event Name: licm, I <br />Organization: 01R <br />Applicant (Contact) Name: i� 1 n o'f,Q <br />Applicant (Contact) Phone: rJ1`I -�4- �� �3 Alt. Phone: <br />Email: L\V\Drar7'�11.�S��ba� <br />Address: � Y3a 1 t ncrglM t , City/State/ZIP: 15rl, 1�bA 2ST 11.'A Wo) <br />Event Location (Please describe): <br />�tty pia, <br />6K�)-od S <br />Length of Event (Dates/Times): D N3 M } <br />PPor}015k- sk� <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 />Authorized Organizer Signature <br />Printed Name and Title <br />