Laserfiche WebLink
Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: �! 1 V � E/ Event Date: <br />Q <br />Event Name: J 5 a, pa�'� <br />Organization: <br />Applicant (Contact) Name: <br />Applicant (Contact) I <br />C <br />Email: ' , `S Y Q <br />Address: <br />Event Location (Please describe): <br />Length of Event (Dates/Times): <br />k <br />— C—. <br />Alt. Phone: <br />City/State/ZIP: <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 />SigOuNd on this Date: 5 <br />Printed Name and Title <br />0 <br />4 <br />