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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />/oZ <br />Date: Eve�ntoDate: �91 � "�, <br />Event Name: �iiISL�O �.l �L ���G J4 {' ar- N <br />Organization: ii<-c C5t4-10- -UI I <br />Applicant (Contact) Name: // <br />Applicant (Contact) Phone: lf�7 �Alt. Phone: <br />Email: i%ia lee7 io19d tedik <br />Address: my pl City/State/ZIP: '-50 R', Kw <br />Event Location (Please describe) <br />Length of Event (Dates/Times): <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 attorneyfees, 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 <br />M <br />Printed Name and Title <br />