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Section K - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />7/8/2025 August 9, 2025 <br />Date: ------------------------- Event Date: --9----------- <br />Event Name: Back to School Boogie Parade <br />---------------------------------------------------- <br />organization: Charles Black Community Center <br />Applicant (Contact) Name: LaResha Johnson/Cynthia Taylor <br />- ------------------------------------ - <br />574-235-7479 574-235-7712 <br />Applicant (Contact) Phone: _ ____ Alt. Phone: <br />---------- <br />Email: Ijohnson@southbendin.gov <br />-------- - -- ----- ----------------------------------------------------- <br />Address: 3419 W. Washington St. — _ city/state/ZIP: South Bend, IN 46619 <br />Event Location (Please describe): <br />Length of Event (Dates/Times):-------- ---------------------------------------- — ---- -----_ <br />Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate, <br />• and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board <br />of Public Works as additionally insured for the event. <br />Organization Name: _ _ agrees to indemnify, defend <br />and hold harmless the Civil City of South Bend, Indiana, from any liability, loss, costs, damages or expenses, <br />including attorney fees, which the Civil City of South Bend, Indiana, may suffer or incur as a result of any claims <br />or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a <br />participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana, <br />through the Board of Public Works, to close a portion of the public right-of-way for the event described above, <br />or for any harm or damage alleged to have occurred because of the holding of the special event. The <br />undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: <br />Authorized Organizer Signature <br />0 Printed Name and Title <br />