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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: 5/512 5( Event Date: -712 � 125 <br />Event Name: t • , Y,n/ aS/ Mj�h Pal o 4-- park, <br />Organization: N <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: (- <br />Email: J Gnu C LhaM4( <br />5 --� wp 0 Alt. Phone: 57 q - 301- 854 <br />hobvi a� C . Coo <br />Address:I �� N • Sltih r�� d4* AV . City/State/ZIP: t R 1 ' tCl 3& , )�J T ol7 <br />Event Location (Please describe): <br />-ff VWaSk i Vjy* S�r-etf bt�wer-v) Sviin i j s Idr and ,Taco►-, <br />Length of Event (Dates/Times): 01' Z &12-5 2 5pM <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: 5 5 Z 5 <br />zed Organizer Signature <br />lot <br />Printed Name and Title <br />0 <br />