Laserfiche WebLink
Section E - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: (i % I a `l I z.- <br />Event Name: <br />Organization <br />Applicant (Cc <br />Applicant (Contact) Phone: .5-7H) qgS 7/ 9 L Alt. Phone: ' 4 <br />Event Date: 87) z s <br />Email: G U Cn -�t YYl I) CL La �)✓yl i ! r a rp,1 <br />J <br />Address: -�101 ly d(/er _L>.—.City/State/ZIP: <br />Event Location (Please describe): fl�.l✓YJf.h �a rL � �o�A.i�G i"lvl N2.QVNefl �i Irl SOS f'�C)' <br />Length of Event <br />lolzs 12prvt'3pm <br />• APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any liability, <br />loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer or incur as <br />a result of any claims or actions which may be made against the City, its agents, employees, or subdivisions by any <br />person, including a participant in the activity, arising out of the approval of this request by the Civil City of South <br />Bend, Indiana, through the Board of Public Works, to close a portion of the public right -of- way for the event <br />described above, or for any harm or damage alleged to have occurred because of the holding of the special event. <br />The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: 2 S <br />Authorized Or anizer Signature <br />Printed Name and Title <br />0 <br />