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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />r i <br />L_J <br />0 <br />Date: S �- 7 —)- S <br />Event Name: f + 5 H ) <br />Organization: <br />Event Date: <br />7'H z sf:7 <br />%-L1-2-5� <br />Applicant (Contact) Name: DON a 1 d 6 /�0 A Q I i N 9 <br />Applicant (Contact) Phone:`/Ozy)°' ;t' - C a X6 Alt. Phone: <br />Email:Do)\l)4fJ,7" 7 /0J/-npf I,coM <br />Address: 7 O 11 f`� S T City/State/ZIP: SOOTff <br />Event Location (Please describe): ✓ 70 6� AI 1 A N 19 7/ )- R/I eN 5 % <br />Ft keWoRkS 5190 ki Fo/Z rH-9-wf-fo/e 57,9-ee7— <br />Length of Event (Dates/Times): 7_ q_ 3-S TO 7- S- ;- $- 1 0 ton TO I /q/7! <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: 7- <br />Authorized Organizer Signature <br />oNPld 13 RoMR l; N9 <br />Printed Name and Title <br />