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Section K - Indemnity & Hold Harmless Agreement <br />LJ <br />U <br />Date: UV I LEsJ <br />Event Name: Organization:% <br />Applicant (Contact) Name: k <br />Applicant (Contact) Phone, <br />Email: rS <br />j <br />Address: L b)' � r L <br />Event Location (Please describe): <br />Length of Event (Dates/Times): _ <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />City/State/ZIP: 52) 3U '—I LCL! lJ <br />(fl�-O(DPAI- 0'tl <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: S •-b -VI's1 'Wqh S&)1Cd agrees to indemnify, defend <br />and hold harmless the Civil City of South 6end, 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: (S.)3. 3-T <br />Authorized Organizer Signature <br />• — ' tl <br />Printed Name and Title <br />