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• <br />Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Applicant (Contact) Phone: 1;-% � -JU — I& -S- 1 Alt. Phone: a 1 q - S � 4 - `t-Wl% <br />Email: <br />Addre <br />D ,(om _ <br />ss: I I 1) S )Af- i& % , 6 kjity1-SY-ate1ZIP: a Jo <br />Event Location (Please describe): <br />Length of Event (Dates/Times): _ q 1 (A I a's <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 11 IdQ 6- <br />Authorized Organizer Signature <br />NnnteaName ana ime <br />M <br />